After hydrodissection, some surgeons also inject balanced salt solution into the substance of the nucleus for hydrodelineation, or separation, of the various layers of the nucleus. This separates the harder endonucleus from the softer epinucleus, which can be left to cushion the underlying posterior capsule. In less brunescent cataracts, a fluid wave can be seen separating the endonucleus from the epinucleus and producing the “golden ring” sign. In cataracts with a white or densely brunescent nucleus, the epinucleus layer may not be present, making hydrodelineation ineffective.
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.