Bimodal capsular bag phacoemulsification: a serial cutting and suction ultrasonic nuclear dissection technique.

A technique for emulsifying the lens nucleus within the capsular bag is presented. The circular continuous tear anterior capsulotomy (capsulorhexis) and nucleus hydrodissection, which are components of the technique, are identified. The concept of isolated cutting and suction as independent actions of the 45-degree ultrasonic phaco-emulsification tip is discussed. The two actions are achieved by alternating the orientation and action of the 45-degree ultrasonic tip in a multiple rotation nuclear dissection technique. The nucleus is collapsed and drawn centrally without aspirating nuclear material while the tip's aperture is near the lens capsule. This technique prevents the ultrasonic tip aperture from bursting through the peripheral nuclear shell and thus reduces the risk of capsular aspiration and vitreous loss.