Intraoperative lens striations: A pivotal visual cue for optimum trench depth in divide-and-conquer phacoemulsification

Determining adequate trench depth during divide-and-conquer phacoemulsification remains a critical yet subjective step, particularly for trainee surgeons. Transverse lenticular striations, observed along the floor of the trench while sculpting, arise from the concentric and lamellar arrangement of lens fibers and become visible during trenching. Building on the observations by Dr Kurien et al ., this article describes their practical utility as a reproducible intraoperative visual cue for trench depth assessment across varying grades of nuclear sclerosis. During trenching, striations typically appear at approximately 20-40% depth, become prominent within the endonucleus, and fade as the posterior nuclear plate is approached. Their disappearance reliably signals adequate depth for safe lateral separation. The technique was applied by 20 trainee and 4 experienced surgeons across multiple cases, demonstrating consistent ease of cracking when separation was attempted after striation fading. This simple, cost-free visual marker reduces uncertainty, enhances training, and improves safety in divide-and-conquer phacoemulsification.

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Publication Details

Journal
Indian Journal of Ophthalmology
Published
2026-10-16
DOI
https://doi.org/10.4103/ijo.ijo_688_26
Primary Topic
Intraocular Surgery and Lenses
Type
article
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article

Intraoperative lens striations: A pivotal visual cue for optimum trench depth in divide-and-conquer phacoemulsification

Bharathi Megur, Deepak Megur, Alka Kulkarni, Poonam
Indian Journal of Ophthalmology
Intraocular Surgery and Lenses
article

Intraoperative lens striations: A pivotal visual cue for optimum trench depth in divide-and-conquer phacoemulsification

Bharathi Megur, Deepak Megur, Alka Kulkarni, Poonam
article en

Abstract

Determining adequate trench depth during divide-and-conquer phacoemulsification remains a critical yet subjective step, particularly for trainee surgeons. Transverse lenticular striations, observed along the floor of the trench while sculpting, arise from the concentric and lamellar arrangement of lens fibers and become visible during trenching. Building on the observations by Dr Kurien et al ., this article describes their practical utility as a reproducible intraoperative visual cue for trench depth assessment across varying grades of nuclear sclerosis. During trenching, striations typically appear at approximately 20-40% depth, become prominent within the endonucleus, and fade as the posterior nuclear plate is approached. Their disappearance reliably signals adequate depth for safe lateral separation. The technique was applied by 20 trainee and 4 experienced surgeons across multiple cases, demonstrating consistent ease of cracking when separation was attempted after striation fading. This simple, cost-free visual marker reduces uncertainty, enhances training, and improves safety in divide-and-conquer phacoemulsification.

Indian Journal of Ophthalmology
Openalex Percentile: Top 9%
Intraocular Surgery and Lenses
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