ew *Corresponding author: Ahmet Colakoglu, MD, School of Medicine, Ophthalmology Department, Acibadem Mehmet Aydinlar University, Zubeyde Hanim Cad, Blok: F26, Daire: 4, Atakoy 1. Kisim Mah, Bakirkoy 34158, Istanbul, Turkey Accepted: August 16, 2021 Published online: August 18, 2021 Citaton: Colakoglu A, Cosar CB (2020) Capsular Bag Irrigaton to Decrease the Tendency of the Iris. A Technique for Bimanual Irrigaton and Aspiraton. J Ophthalmic Surg 3(1):33-34 Journal of Ophthalmic Surgery Open Access | Page 33 | Vol 4 | Issue 1 | Pages 33-34 ISSN: 2578-7160 Copyright: © 2021 Colakoglu A, et al. This is an open-access artcle distributed under the terms of the Creatve Commons Atributon License, which permits unrestricted use, distributon, and reproducton in any medium, provided the original author and source are credited. SchOlArly PAgeS SCHOLARS. DIRECT DOI: 10.36959/587/596 Capsular Bag Irrigation to Decrease the Tendency of the Iris. A Technique for Bimanual Irrigation and Aspiration Ahmet Colakoglu, MD * and Cemile Banu Cosar, MD, Phd School of Medicine, Ophthalmology Department, Acibadem Mehmet Aydinlar University, Istanbul, Turkey Dear Editor, We would like to introduce a simple technique for the bimanual irrigaton and aspiraton (I/A) of ophthalmic vis- cosurgical device (OVD) and cortcal material during cataract surgery. Iris prolapse occurs when the forces pulling on the iris to- ward the wound exceed the ability of the iris’ tone to main- tain the positon of the iris in the anterior chamber [1]. Anterior wound placement should help to prevent iris prolapse. Minimizing the irrigaton velocity, and hence the fuid outlow velocity should also help to prevent intraoper- atve prolapse [2]. Many surgeons prefer not to place the irrigaton/aspira- ton (I/A) tp behind the optc during removal of an ophthal- mic viscosurgical device (OVD) for fear of inducing a posterior capsule rupture [3]. We had been using irrigaton tp to push IOL optc side- ways and irrigate retrolentcular space to ease removal of OVD via aspiratng cannula. We have observed that the in- tracapsular irrigaton maintained the intraoperatve positon of the iris with adequate formaton of the capsular bag and anterior chamber even during removal of the OVD from the anterior chamber. Then we have decided to use capsular bag irrigaton during cortex removal as well. Iris prolapse was seen to occur less frequently. Afer phacoemulsifcaton is completed, the irrigaton can- nula is directed into the capsular bag to achive irrigaton in the capsular bag. In our technique irrigaton tp is introduced into the capsular bag without a stop in the anterior chamber while the aspiraton tp is held just in the tunnel of the other side port occluding it and preventng egress of fuid from the anterior chamber. While traversing the anterior chamber, the infow is ob- served to cause some futer of the iris and a slight forward movement of the iris, but afer positoning the irrigaton tp in the capsular bag the iris is seen to move backward and stop futering. Being placed in the capsular bag and the directon of egressing fuid towards the lens equator, the irrigaton cannula provides excellent iris stability and positoning, and Short Communication Check for updates it also keeps the anterior chamber and capsular bag well dis- tended for easy removal of cortex via the aspiraton tp insert- ed through the other side port. Afer complete cortcal cleanup is accomplished, OVD is used to fll the anterior chamber and the capsular bag. IOL is implanted as usual. Then the irrigaiton tp is placed in the cap- sular bag below the level of anterior capsule while the anteri- or chamber is stll flled with the OVD and before the IOL has been centered. The aspiraton port is placed in the capsular bag facing the cornea, and is positoned behind the IOL optc with the IOL stll slightly decentered. Then the OVD is removed from the anterior chamber while the irrigaton tp is stll kept in the capsular bag. By using this technique we should have reduced the veloc- ity of fuid fowing in the anterior chamber. By directng irri- gaton fow into the capsular bag we should have the chance for beter endothelial protecton otherwise irrigaton soluton turbulence in the anterior chamber could cause more endo- thelial damage [4]. We found this technique to be safe and efectve in re- ducing the frequency of iris prolapse during bimanual I/A. The other advantages are increased anterior chamber depth, pupillary dilaton maintenance during I/A, and well-distended capsular bag helping in the avoidance of accidental posterior capsule capture and rent. References 1. Chan DG, Francis IC (2005) Intraoperatve management of iris prolapse using iris hooks. J Cataract Refract Surg 31: 1694-1696.