Life expectancy of the population increase and cataract development will affect all the people with aging. Cataract surgery, a worldwide performed procedure, evolves and progresses. However, different techniques exist, which could be selected for different cases. Any ideal technique should be safe, simple, fast, and easy to learn with good clinical outcome. This chapter will describe one technique to operate cataracts with those characteristics and to perform phacoemulsification cataract surgery without viscoelastic substance. Some advantages of this technique are related to avoiding viscoelastic potential problems, as postoperative intraocular pressure elevation or anterior chamber inflammation associated with viscoelastic. Moreover, a fundamental factor to remark is the difference between work into the anterior chamber with negative pressure or positive pressure. Because the anterior chamber is maintained by the balanced salt solution with the continuous irrigation without viscoelastic. Performing the capsulorhexis is easier. Other advantages are shorten surgical time, fewer economical cost, and potentially fewer complications. Some limitations are as follows: intraocular lens must be one piece foldable, and principally, patients with corneal endothelial pathology must be excluded. Tips, step-by-step surgery, recommendations, and evolution of the technique will be described, with the wish that many surgeons will try to perform Bianchi’s method (bimanual, microincision phacoemulsification cataract surgery without viscoelastic substance) for your next patient.
Part of the book: Difficulties in Cataract Surgery