Symmetric Bimanual Phacofragmentation: A New Approach for Nucleus Disassembly

Abstract

Purpose To describe a new technique to split the lens nucleus inside the capsular bag, using a novel pair of instruments. Methods Two identical instruments are employed on the horizontal axis to promote nuclear splitting into 2 or more fragments. Each instrument has a portion that functions as a hook (H); an anterior edge, opposite to the hook, which acts as a knife (K); and a surface area located between the hook and knife, which functions as a cracker (C). Results Nuclei up to grade 4 nuclear sclerosis were successfully fractured employing this technique. Conclusions Symmetric bimanual phacofragmentation with HKC instruments provides effective bimanual splitting of nuclei for phacoemulsification, also allowing depth adjustment of cleavage plane, and can be applied for a wide range of nuclear densities.