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    Brunescent Circumferential Disassembly

    By Lisa B. Arbisser, MD
    Editors' Choice
    Cataract/Anterior Segment

    Dr. Lisa Arbisser demonstrates her approach for managing a brunescent or rock-hard cataract. A technique she started in 2003, the circumferential disassembly with a cross-action vertical chop is an efficient method of debulking the lens from the inside out. Using noncontinuous phacoemulsification and a Rosen splitter, Dr. Arbisser relies on short bursts of energy to create multiple superficial radial chops, slowly debulking the endonucleus away from the outer nucleus and epinucleus. In this video, she applies the technique in 3 patient cases: a post-retinal detachment with a rock-hard cataract and ischemic iris; a post-vitrectomy cataract; and a coloboma.