Optimizing refractive lens exchange with bimanual microincision phacoemulsification.

Bimanual microincision phacoemulsification entails the removal of the crystalline lens through 2 1.2 mm incisions. Infusion is provided through a separate irrigating handpiece, and phacoemulsification and aspiration are performed through a sleeveless phacoemulsification needle. We describe a technique for refractive lens exchange using bimanual microincision phacoemulsification. Capsulorhexis formation, cortical cleaving hydrodissection, lens extraction in the iris plane, and residual cortex removal are performed through the microincisions. This technique offers improved surgeon control throughout the procedure and added safety by maintaining continuous pressurization of the eye while removing the lens far from the posterior capsule.