Artisan-Verysise IOL implantation seems a safe, predictable, and effective option for aphakic eyes without capsule support.

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We describe a phacoemulsification technique for soft and medium-hard cataracts to decrease phaco time and enhance the safety of the procedure. After conventional hydrodissection and hydrodelamination are performed, a 15- or 30-degree phaco tip is positioned on the peripheral lens beside the capsulorhexis edge and in contact with the nucleus-epinucleus interface. The lens is then aspirated onto the phaco tip. Phacoemulsification is started with the ultrasound energy level limited to 15% to 25% depending on the nuclear hardness and with linear aspiration power up to 250 mmHg. The phaco tip is slightly displaced to the vertex of the pupil to keep it occluded, and the lens is rotated. The phaco tip is placed in the same area and a modified manipulator used to keep the lens in a horizontal position during rotational movement. The small, hard, central nucleus is usually emulsified at the end.

This combined technique was effective in the treatment of high astigmatism, with excellent results compared with the results of each procedure alone. Because of its high predictability, we strongly recommend the technique in cases with astigmatism higher than 3.0 D, particularly in those with astigmatism higher than 5.0 D.

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