What is the Difference Between Hydrodissection and Hydrodelineation?

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Hydrodissection and hydrodelineation are both techniques used in cataract surgery, but they serve different purposes and have distinct effects on the lens:

Hydrodissection:

  • Separates the lens capsule from the lens cortex.
  • Detaches the lens, freeing it from its surrounding capsule, facilitating easier extraction during phacoemulsification.
  • Reduces the risk of capsular rupture during cortical extraction.

Hydrodelineation:

  • Splits the lens into endonuclear and epinuclear sections, reducing the size of the hard nucleus, making its extraction possible through a smaller incision.
  • Facilitates phacoemulsification by maintaining the shape of the capsule and providing an effective buffer protecting the posterior capsule membrane.

While both techniques involve injecting fluid into the lens, hydrodissection focuses on separating the lens capsule from the cataract cortex, whereas hydrodelineation aims to divide the lens into endonuclear and epinuclear sections, making the extraction of the hard nucleus easier. Some surgeons may choose not to perform hydrodelineation, preferring to remove the entire nucleus without separating it into layers.

Comparative Table: Hydrodissection vs Hydrodelineation

Here is a table comparing the differences between hydrodissection and hydrodelineation:

Feature Hydrodissection Hydrodelineation
Definition A technique used in cataract surgery to free the lens from the capsular bag, facilitating easier extraction during phacoemulsification. A technique similar to hydrodissection, performed with the goal of separating the epinucleus and endonucleus.
Location Occurs between the lens capsule and lens cortex. Occurs between the endonucleus and epinucleus.
Purpose To free the adhesions of the cataract from the capsular bag and facilitate easier cortical cleanup, reducing the risk of capsular rupture during cortical extraction. To maintain the epinuclear shell as a protective coat, keeping the capsule stretched and preventing it from tearing.
Technique A cannula containing a balanced salt solution is directed towards the central plane of the lens. A cannula containing a balanced salt solution is directed towards the central plane of the lens.
Outcome Successful hydrodissection results in the nucleus being freely mobile and detached from its surrounding capsule. Successful hydrodelineation results in a golden ring or dark circle around the endonucleus, signifying a circumferential division of the nucleus.

Both hydrodissection and hydrodelineation are vital steps in cataract surgery that require a cannula containing a balanced salt solution and use ultrasound for phacoemulsification.