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Phaco Tips > Phaco
Tip 122: Capsulorhexis and the Shallow Chamber
When performing capsulorhexis in an eye with a shallow
anterior chamber, special techniques may be useful. In a previous phaco
tips column (Phaco Tip 86), I described the use of a spatula inserted
through a sideport incision to depress the nucleus during the capsulorhexis.
This maneuver aids in maintaining anterior chamber depth, reduces tension
on the anterior capsule during the rhexis, and reduces the possibility
of peripheral extension of the capsular tear.
In some shallow-chambered eyes, insertion of a capsulorhexis
forceps results in iris prolapse and/or further chamber shallowing. In
this situation, the use of a bent-tip needle to perform the capsulorhexis
can be extremely useful. The needle should be inserted through a small
sideport incision in order to maintain chamber depth by preventing escape
of viscoelastic. The approach at the anterior capsule is facilitated by
angulting the needle near its hub. In addition, because the globe will
tend to move as the bent-tip needle is repositioned and manipulated, the
insertion of a spatula through an additional sideport incision is extremely
valuable. This will stabilize the globe, and greatly facilitate the performance
of the capsulorhexis.
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