The "Water Jet" technique for polishing the posterior capsule in cataract surgery

1. Gaurav Bhardwaj
2. Jenny L. Lauschke
3. Ian C. Francis

1. The Prince of Wales Hospital, Randwick, Australia
2. University of New South Wales, Sydney, Australia
3. Ophthalmic Surgery Centre, Chatswood, Australia

After cortical aspiration in phacoemulsification cataract surgery using traditional automated irrigation/aspiration, residual cortical fibres are commonly present on the posterior capsule (PC). We report a new manual technique for polishing the PC. This Water Jet technique utilises a standard 27G hydrodissection cannula with a 3mL luer-lock syringe of balanced salt solution.

The water jet technique has been evaluated in a prospective, consecutive case series of 150 procedures. The mean time taken to achieve a clear PC was 33.6 seconds. Its effectiveness was documented on a linear scale from 0-3, where 0 = ineffective, 1 = somewhat effective, 2 = very effective, 3 = 100% effective (clear PC). An effectiveness of 3 was achieved in 85.3% of cases in which RCF were present. There were no operative complications associated with the technique.

The technique is inexpensive, rapid, and relatively non-invasive. An added advantage is that it often mobilises tenacious peripheral cortex when other techniques may have proved inadequate.

Furthermore, the Water Jet technique may remove peripheral lens epithelial cells, ultimately resulting in minimisation of PC opacification. This is currently being studied in a longterm prospective consecutive followup study.