ABSTRACT
One of the main bugbears of phacoemulsification is surge.1 The problem is that as the nuclear piece gets occluded in the phaco tip and we emulsify it, surge occurs. Many people have tried various methods to solve this problem. Some phaco machines like the Sovereign have been devised with the help of I Howard Fine, Barry Seibel and William Fishkind to solve this problem. Others have tried to use an anterior chamber maintainer to get more fluid into the eye. The problem with the anterior chamber maintainer is that another port has to be made. In other words, now we have three ports and if you are doing the case under topical or no anesthesia (as we do in our hospital) it becomes quite cumbersome. Another method to solve surge is to use more of phacoaspiration and chop the nuclear pieces with the left hand (non-dominant hand). The problem by this is the surgical time decreases and if the case is of a hard brown cataract, phacoaspiration will not suffice.
