The use of a mixture of HPMC 2.25% and lidocaine 1% rather than a regular viscoelastic agent resulted in clinically and statistically significantly reduced pain/discomfort during phacoemulsification.
A mixture of Fluorescein 0.25% and methyl cellulose 0.25% is used for hydrodissection. Standard phacoemulsification is then continued until the initial groove reaches the plane between the lens cortex and the capsule when the fluorescein flows towards the anterior chamber in a Green Smoke. This sign indicates a proper depth for attempting to crack the nucleus into two halves.
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