Chief & Presenting Author: Dr.Kumar Doctor

Abstract

Following Phaco, Co-axial I/A was a standard norm, then came the invent of the bimanual I/A. This separation of the irrigation and aspiration made the sub incisional cortex removal very easy. In FLACS, the cortical fibres get cut 300μ below the CCC, therefore there are no free floating cortical fibrils seen and the I/A step needs a modification of technique. So,in FLACS to do bimanual, one has to go below the CCC to actually hold the cortex and increase the vaccuum and aspirate it. If the pupil comes down beyond the CCC, then the bimanual I/A becomes difficult as there are no free cortical fibrils seen for aspiration. In such a scenario one can use the bimanual I/A and the irrigating handle to push the iris away to visualise the cortex. But this always slips and is tough to hold on to the iris. So came the invent of modification of the irrigation handle called THE THIRD HAND.This will help to move and hold the iris away during bimanual to visualise the cortical end for safe aspiration.