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Q. Phacoemulsification Step by Step - Irrigation & Aspiration of Viscoelastic (1)

Removal of the viscoelastic device with irrigation and aspiration is done in a systematic fashion. The irrigation and aspiration probe tip removes the central viscoelastic material and then is directed into each quadrant of the anterior chamber. Particular care is taken to remove the dispersive viscoelastic adjacent to the endothelium as the tip needs to be close but not touch. Next the viscoelastic around the intraocular lens is removed using the “rock and roll” technique, gently moving the lens from side to side with the tip of the probe. This should remove the majority of the viscoelastic however, a technique to remove the viscoelastic from behind the lens is an important skill. There are potential hazards when placing the tip of the probe behind the lens – damage to the posterior capsule with the tip or suction, stress to the capsular bag and potential for zonular dehiscence, vitreous loss and lens subluxation and/or dislocation. Complete viscoelastic removal is critical to preventing post-operative intraocular pressure spiking.