Hydrodissection-free phacoemulsification surgery: mechanical cortical cleaving dissection.

UNLABELLED: We describe hydrodissection-free phacoemulsification surgery (hydro-free phaco), which eliminates conventional cortical-cleaving hydrodissection during cataract surgery. To replace hydrodissection, we devised a mechanical cortical-cleaving dissection technique that is performed during phacoemulsification. The new technique prevents the high pressure within the endocapsular space or the posterior chamber-anterior hyaloid membrane barrier area that is common with hydrodissection. This reduces hydrodissection-related complications such as posterior capsule rupture, anterior hyaloid membrane tear, extension of zonule fracture, and pseudoexpulsive hemorrhage. Using this technique, phacoemulsification was performed effectively without complications in 547 of 550 cataract eyes. We propose this technique to prevent hydrodissection-related complications in eyes with a high risk for complications. FINANCIAL DISCLOSURE: Neither author has a financial or proprietary interest in any material or method mentioned.