[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-456548-105":59,"doc-detail-456548-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","hydro-chronicles-hydrodissection-hydrodelamination-review","Hydro chronicles - Hydrodissection & Hydrodelamination Review","","This review article is based on the 2025 ASCRS Binkhorst Lecture delivered by Ron Yeoh, focusing on the basic yet often neglected step in phacoemulsification: hydrodissection. Drawing on four decades of experience, it explains techniques aimed at achieving nuclear mobility and discusses how intraoperative OCT, introduced in 2017, enables live imaging of hydrodissection and hydrodelamination to clarify cleavage planes. The article analyzes complications such as the “pupil snap sign” and reviews the relevance of hydrodissection in modern cataract surgery.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/hydro-chronicles-hydrodissection-hydrodelamination-review/456548/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/hydro-chronicles-hydrodissection-hydrodelamination-review/456548.png","ImageObject",300,407,{"name":92,"@type":93},"RuangKosong","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":19},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What is the main focus of the Hydro chronicles review?","Question",{"text":112,"@type":113},"It focuses on hydrodissection in phacoemulsification, including related hydrodelamination and key complications such as the “pupil snap sign.”","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How does intraoperative OCT contribute to understanding hydrodissection?",{"text":117,"@type":113},"Introduced in 2017, intraoperative OCT enables live imaging of hydrodissection and hydrodelamination, helping clarify cleavage planes.",{"name":119,"@type":110,"acceptedAnswer":120},"What signs indicate adequate hydrodissection?",{"text":121,"@type":113},"The article describes three cardinal signs: fluid wave, nucleus lift, and nucleus prolapse/complications when excessive force is used, supported by three subsidiary observations.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},456548,1790790304,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":19,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":19,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":52,"preview_page_count":4},962090883219,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","| Access this article online |\n| --- |\n| Quick Response Code: |\n| |\n| Website:\u003Cbr>[http://journals.lww.com/TJOP](http://journals.lww.com/TJOP) |\n| DOI:\u003Cbr>10.4103/tjo.TJO-D-25-00075 |\n\nPresident IIIC (International Intraocular Implant Club)  \n*Address for correspondence:  \nDr. Ron Yeoh, President  \nIIIC (International Intraocular Implant Club) . E-mail: ersryeoh@ [gmail.com](gmail.com)  \nSubmission: 06-05-2025  \nAccepted: 15-06-2025  \nPublished: 22-12-2025  \nReview Article-Narrative Review  \nTaiwan J Ophthalmol 2025;15:545‑548  \nHydro chronicles  \nRonald Yeoh*  \nAbstract:  \nThis article is based on the 2025 ASCRS Binkhorst Lecture which I delivered in Los Angles in April 2025. It will focus on the basic but oft-neglected step in phacoemulsification: hydrodissection. Over a 40 year career, I have had a particular interest in the techniques of ‘hydro’ manoeuvres to achieve nuclear mobility. The introduction of intra-operative OCT in 2017 allowed ‘live’ imaging of hydrodissection and hydrodelamination helping in our understanding of cleavage planes. Complications of hydrodissection like the ‘pupil snap sign’ will be analysed and the relevance of hydrodissection in modern cataract surgery discussed.  \nKeywords:  \nHydrodissection, Hydrodelamination, intraoperative OCT, Cortico-capsular adhesions, pupil snap sign, capsular block syndrome  \nThis article is based on the Binkhorst  \nMedal lecture titled “Hydro Chronicles”which I presented at the April 2025 ASCRS meeting in Los Angeles, USA.  \nMy interest and love affair with hydrodissection started in 1993 when I was a young and inexperienced phaco surgeon. I had been unimpressed by my hydrodissection technique and thought that hydrodissection through the side port would be more efficient as the anterior chamber would be more watertight. Unfortunately, as I hydrodissected through the side port, the pupil abruptly constricted and this was followed shortly by the nucleus tilting and descending into the vitreous cavity. I managed to retrieve the nucleus using a Vectis and after an anterior vitrectomy was able to implant a 3 piece lens into the sulcus. What I had witnessed was the“Pupil snap sign of hydrorupture of the posterior capsule” and I published in the BJO in 1995.[1]  \nThe“PupilSnap”sign occurs when excessive force is used during hydrodissection and the  \nfluid that is injected ruptures the posterior  \nThis is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercialNoDerivatives 4.0 License (CC BY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.  \nFor reprints [contact:](contact: WKHLRPMedknow_reprints@wolterskluwer.com)[ WKHLRPMedknow_reprints@wolterskluwer.com](contact: WKHLRPMedknow_reprints@wolterskluwer.com)  \ncapsule instead of going all the way around the nucleus to the other side [Figure 1] . Asthe posterior capsule ruptures, the nucleus abruptly descends away from the iris and it is this that causes the pupil to constrict.  \nRecognition of the “Pupil Snap” sign is important because steps can be taken to do“slow motion”phacoat lowered parameters which reduce the risk of a nucleus drop or atthe very least, the surgeon is prepared with vitreoretinal backup. If there is one good thing about a hydrorupture of the posterior capsule, it is that the anterior capsular rim is usually unaffected and a three‑piece lens is easily inserted into the sulcus.  \nTip: Do not hydrodissect through the side port.  \nThis complication stimulated my interest in hydrodissection and hydrodelamination and over the past 30 years, I have studied and analyzed these maneuvers carefully.  \nStandard Hydrodissection  \nHydrodissection to free the nucleus is the cornerstone of most nuclear removal techniques in phaco. Every cataract surgeon is aware that the occurrence and sighting of the fluid wave indicate good hydrodissecti","cbCaigA5zIThWFmG","https://ap.wps.com/l/cbCaigA5zIThWFmG","pdf",1361313,"English","# Hydro chronicles\n## Hydrodissection: purpose, imaging, and complications\n## Standard hydrodissection: cardinal and subsidiary signs\n## Hydrodelamination: technique and visual cues","[{\"question\":\"What is the main focus of the Hydro chronicles review?\",\"answer\":\"It focuses on hydrodissection in phacoemulsification, including related hydrodelamination and key complications such as the “pupil snap sign.”\"},{\"question\":\"How does intraoperative OCT contribute to understanding hydrodissection?\",\"answer\":\"Introduced in 2017, intraoperative OCT enables live imaging of hydrodissection and hydrodelamination, helping clarify cleavage planes.\"},{\"question\":\"What signs indicate adequate hydrodissection?\",\"answer\":\"The article describes three cardinal signs: fluid wave, nucleus lift, and nucleus prolapse/complications when excessive force is used, supported by three subsidiary observations.\"}]","Hydro chronicles - Hydrodissection & Hydrodelamination Review | PDF",1790746359]