title: Y sign: clinical indicator to stop trenching and start cracking.
abstract: Phacoemulsification is challenging in soft cataracts due to the difficulty in cracking the nucleus by a divide-and-conquer technique or by chopping. We describe another technique, the Y sign for trenching endpoint: a clinical sign that indicates the surgeon should stop trenching and start cracking during classical divide-and-conquer nucleofractis emulsification using proximal downslope trenching. This technique exploits the morphological structure of the lens to precisely gauge the depth of the trench at which the surgeon can split even a soft nucleus into small wedges without instrument cheese-wiring and thus perform safer phacoemulsification while reducing the risk for posterior capsule rupture.
authors.affiliation: Cataract and Refractive Lens Surgery Service, Narayana Nethralaya, Post-Graduate Institute of Ophthalmology, Bangalore, India. dr.mkurian@gmail.com
authors.forename: Mathew
authors.initials: M
authors.lastname: Kurian
authors.forename: Sudeep
authors.initials: S
authors.lastname: Das
authors.forename: B
authors.initials: B
authors.lastname: Umarani
authors.forename: Somshekar
authors.initials: S
authors.lastname: Nagappa
authors.forename: Rohit
authors.initials: R
authors.lastname: Shetty
authors.forename: Bhujang K
authors.initials: BK
authors.lastname: Shetty
mesh_terms: D006801:Humans; D007903:Lens Capsule, Crystalline / Q000601:surgery*; D007907:Lens Nucleus, Crystalline / Q000601:surgery*; D018918:Phacoemulsification / Q000379:methods*