The paracentesis incision is used for multiple purposes, including insertion of a second instrument, introduction of intracameral additives, and placement of iris hooks. A small sharp blade, such as a 15° blade or microvitreoretinal (MVR) blade, is used to create 1 or 2 paracentesis incisions approximately 2 or 3 clock-hours away from the site where an incision will be made for the phaco handpiece. A straight entry plane is made parallel to the iris or at a slight downward angle. Alternatively, these incisions may be made by femtosecond laser (see the section Alternative Technologies for Cataract Extraction later in this chapter). Once the paracentesis is complete, an ophthalmic viscosurgical device (OVD; also referred to as a viscoelastic agent; see Chapter 7) is often instilled to protect intraocular structures and to give the surgeon more control during creation of the phaco incision.
Figure 8-6 Eyelid specula. A, Lieberman speculum. B, Open-loop speculum (left) and closed-loop wire speculum (right).
(Courtesy of Lisa Park, MD.)
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.