Tại các kết luận của phacoemulsification bimanual, có lẽ sự thất vọng lớn nhất là cần phải đặt một đường rạch 2,5 mm tương đối lớn giữa hai microincisions để cấy ghép một IOL có thể gập lại. Một sự tương tự với những ngày, khi phacoemulsification được thực hiện thông qua các vết rạch | 196 M. Packer . Hoffman Fig. . The roughened aspirator allows removal of cortical material and polishing of the capsule Fig. . This blunt smooth dual-side port irrigator may be used during irri-gation aspiration to safely manipulate cortical or epinu-clear material in the capsular bag through these microincisions. At the conclusion of bimanual phacoemulsification perhaps the greatest disappointment is the need to place a relatively large incision between the two microincisions in order to implant a foldable IOL. An analogy to the days when phacoemulsification was performed through incisions that required widening to mm for PMMA IOL implantation is clear. Similarly we believe the advantages of bimanual phacoemulsification will prompt many surgeons to try this technique with the hopes that the holy grail of microincision lenses will ultimately catch up with technique. Although these lenses are currently not available in the USA companies are developing lens technologies that will be able to employ these tiny incisions. Ultimately it is the surgeons who will dictate how cataract technique will evolve. The hazards of and prolonged recovery from large-incision intra- and extracapsular surgery eventually spurred the development of phacoemulsification. Surgeons who were comfortable with their extracapsular skills disparaged phacoemulsification until the advantages were too powerful to ignore. Similar inertia has been evident in the transition to foldable IOLs clear corneal incisions and topical anesthesia. Yet the use of these practices is increasing yearly. Whether bimanual phacoemulsification becomes the future procedure of choice or just a whim will eventually be decided by its potential advantages over traditional methods and by the collaboration of surgeons and industry to deliver safe and effective technology. References 1. Girard LJ 1978 Ultrasonic fragmentation for cataract extraction and cataract complications. Adv .
