Cortical aspiration - The “POPS” technique

In the present study, we describe a step-by-step technique for cortex aspiration during cataract surgery- POPS (positioning, occlusion, posterior displacement, and swiping). Firstly, the aspiration probe is positioned under the bulk of cortical fibers beyond the capsulorhexis margin. Subsequently, the aspiration port is occluded with minimal vacuum, and the occluded port is displaced posteriorly to detach the cortical fibers off the anterior capsule. Now, tangential, arc-like swiping movements are performed while gradually increasing vacuum at the same time. The fibers are brought to the center and finally aspirated. This allows complete removal of the equatorial fibers and lens epithelial cells (LEC) with the least stress to the capsulozonular complex. Unlike the conventional technique, which involves the radial pull of cortical fibers, in this technique, there is swiping and posterior displacement of the cortical fibers before pulling towards the center and aspirating. We believe this technique will ensure safer, more effective cortical and LEC removal, reducing zonular stress.