Epinucleus Scraping: Safe New Phacoemulsification Technique for Rock-Hard Cataracts

Aki Kondo1, *, Mari Goto2, Tatsuya Mimura3, Shunichi Tanaka4, Masao Matsubara5
1 Ando Eye Clinic, Kanagawa, Japan
2 Department of Ophthalmology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
3 Department of Ophthalmology, Teikyo University, Tokyo, Japan
4 Shimizu Eye Clinic, Tokyo, Japan
5 Yaesu Sakura Eye Clinic, Tokyo, Japan

© 2021 Kondo et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Ando Eye Clinic 965-1 Souryo Matsuda Kamiashigara Kanagawa, Japan; Tel: +81-465834545; E-mail:



Phacoemulsification of rock-hard cataracts is challenging because the leathery epinucleus at the posterior plate often found in such cataracts tends to prevent smooth dissection of the nucleus. We devised an Epinucleus scraping technique to overcome this problem.


The epinucleus is initially stripped of the hard endonucleus using a new instrument. The isolated endonucleus can then be readily chopped and divided with a phaco chopper or in the usual manner.


Phacoemulsification of rock-hard cataracts can be carried out safely and easily with epinucleus scraping technique.

Keywords: Cataract surgery, Rock-hard cataract, Phacoemulsification, Epinucleus, Endonucleus, Phaco chopper.