About Video

This video demonstrates the phaco ‘Chop Technique’ is the fastest technique for nucleus removal and requires minimum ultrasound for emulsification. It was developed by the Japanese ophthalmologist Nagahara in 1993 and is now a commonly used phaco surgical technique. Ultrasound is harmful to the eye, especially to the endothelium of the cornea. Therefore, for all phaco surgeries, the surgeon should use minimum ultrasound, which means short phaco time. Before starting, check the settings of your machine. A commonly used setting is: 60% phaco power, 25 mL/min flow rate, 275 mm Hg vacuum and 130 cm bottle height above the patient’s eye, which is equal to 102 mm Mercury. The surgeon prefers to use burst mode. For phaco chop, we prefer to use angulated, flared tips with a wider opening at the end. These tips have a better nucleus-holding capacity. They are either from a Swiss or German company. First remove superficial cortex in irrigation/aspiration foot pedal position. Then enter into the middle of the nucleus, catch it, lift it up, engage the chopper from the side and partly behind the nucleus, and break the nucleus into two parts, continue to break it into smaller pieces and emulsify piece by piece. The reason for lifting up the nucleus is to get it away from the posterior capsule, avoiding pressure, which might lead to posterior capsule rupture (PCR). PCR is a severe complication, which every phaco surgeon needs to avoid.