Tri-Soft shell Technique Arsinoff

Soft Shell Technique introduced by S Arshinoff (Toronto Canada) is taking advantage of the different properties of Viscoelastics.

1/ First you introduce the Dispersive Viscoelastic (eg Viscoat) centrally over the crystalline lens

2/ then you introduce the Cohesive Viscoelastic (eg Healon GV) below the first thus i) creating/ maintaining space ii) pushing the dispersive where you need it the most: over the endothelium.

The tri-soft Shell addentum is using 1/ Dispersive 2/ Superviscoadaptive eg Healon 5 3/ BSS- Trypan blue behind…just over capsule…..the dye should never touch the endothelium…….

https://eyetube.net/series/eyetube-tv-show-daily-vienna-2011/optimizing-viscoelastic-softshell-technique/

the Sideways Arsinoff Shell: you have a zonular dehiscense: place Dispersive on the weak side and cohesive to push the dispersive to plug the hole……