If hydrodissection has succeeded in breaking the attachments between the peripheral and posterior cortex and the posterior capsule, the surgeon should be able to rotate the nucleus within the capsular bag. Phacoemulsification techniques are easier to perform when the lens rotates freely. Difficulty in rotation may suggest inadequate hydrodissection, loose zonular fibers, or posterior capsule rupture. Attempting to rotate the nucleus in patients with loose zonular fibers can weaken the stability of the capsular bag.
Excerpted from BCSC 2020-2021 series: Section 11 - Lens and Cataract. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.