Phaco Training: Cortex aspiration with Simcoe

By | September 1, 2016

Simcoe irrigating and aspiration cannula comes in different bore sizes.

From 21 gauge to 24 gauge.

Which gauge is preferable?

Do narrower and thinner Simcoe keep the AC better formed?

Secondly, for the tight handed surgeons, how often do they need to make a side post at the 3 o clock position and use the reverse Simcoe to tackle the 9 o clock cortex?

Here are some of the responses from the masters.


Dr. M.S. Ravindra

Only the infusion quantity varies with the gauge size.

Aspiration depends on the size of the port or the hole.

0.3 mm diameter is ideal to hold the cortex and to suck or pull.

You can also have Simcoe with larger irrigation cannula say 22 G and thinner aspiration, say 23 G.

Finer bore get blocked faster.


Dr. Minu Mathen

Use Indo German Simcoe 20 or 21 gauge

Important thing is the relative sizes of the irrigating and aspirating ports rather than absolute gauge of Simcoe cannula

Not to use very narrow Simcoe

First aspirate the 9 o clock cortex which is the most difficult

In the beginning, fill the bag with viscoe and aspirate the cortex at 9 o clock

Use the main port, go full nasally to prevent AC shallowing

Make the side port slightly inferior to 9 o clock position

Side port must be clear corneal and slightly larger then your Simcoe