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Step down technique for endocapsular emulsification

Vasavada A, Shetal R
Ahmedabad/Indien

To report the technique for safe endocapsular phacoemulsifi-
cation in dense cataracts. With progressive removal of fragments,
from the capsular bag and proportionate greater exposure of po-
sterior capsule. The preset vacuum, phaco energy and aspiration
flow rate are reduced in a step by step manner. Instead of bringing
the phacotip and the lens fragment anteriorly towards the endo-
thelium, all the lens fragments are consumed within the bag by
keeping the phaco tip stationery. All the 3 preset parameters i.e.
vacuum, phaco energy & aspiration flow rate are modulated i.e.
for safe removal of lens fragment from within the bag. This also
reduces turbulence. The logistics and its comparision with the
standard technique are highlighted. This techniques has been
practised for 18 months with excellent intraoperative control,
satisfactory postoperative outcome. No serious complications ha-
ve been noted. This technique is simple and easy to learn. It
enhances the surgeon's control in managing adverse situations
e.g. small pupil. Step Down Technique enables the surgeon to
perform safe endocapsular emulsification in dense/very dense
cataracts.



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