Cataract surgery has undergone remarkable refinement over the past decades, yet some of the most elegant maneuvers remain those that are not routinely emphasized in textbooks or lectures.
These microtechniques, sometimes passed from mentor to trainee in the operating room, can profoundly influence fluidics control, visualization and efficiency. Three of my favorite secret techniques are repositioning cortical opacities to enhance red reflex during capsulorrhexis; the strategic lateral displacement of a heminucleus during phaco chop to facilitate extraction of the other half; and flipping the