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Aim
A patent side port.
Principles
Stabilize the eye with a Thornton ring or alternative.
You will know from your programmed parameters how many degrees your side ports will be from your main incision. They can sometimes be difficult to find. If so, dry the cornea and they may be easier to see.
The incision is much more horizontal or “flatter “than you imagine.
Move the Slade spatula in a plane horizontal to the iris. Force is not required.
When using a blade to enter the eye you can see the tip enter into the anterior chamber. In femtosecond laser surgery you may not be sure where the opening through the endothelium is. Sweeping vigorously from side to side in order to open the wound is not encouraged.
Insert the cannula of the viscoelastic syringe and fill the anterior chamber starting in the anterior chamber distal to the entry. By placing your cannula across and over the central pupillary area you ensure that the viscoelastic is above the capsulorhexis. This also will allow any bubbles to be moved towards the limbus and then towards the incision site and away from the central pupillary area.
Avoid injecting viscoelastic underneath the free capsular flap as it then will roll into the angle of the eye, (which is not a problem as it can be easily removed but it does take away the flourish with which you can usually remove the central capsule.)
Do not overfill the anterior chamber.
Tip
A small amount of Balanced Salt Solution (BSS) mixed with unpreserved phenylephrine (with or without lignocaine) injected before the viscoelastic will help to re-dilate a pupil which may have constricted.