Divide and conquer nucleofractis phacoemulsification: development and variations.

Abstract

Cataract extraction by phacoemulsification of the lens in situ can be accomplished by a technique incorporating continuous curvilinear capsulorhexis (CCC), deep central sculpting of the nucleus, and manual cracking ("nucleofractis") and subsequent fragmentation and emulsification of the remaining nucleus. This "divide and conquer" nucleofractis technique of phacoemulsification is uniquely suited to the constraints that CCC, which provides excellent conditions for well-centered in-the-bag placement of intraocular lenses, imposes upon cataract extraction. The cracking and fragmentation maneuvers allow phacoemulsification to be extended to patients with hypermature and brunescent lenses, as well as small pupils, who are not normally considered good candidates for the technique.