Beginning Surgeon Stop-and-Chop Case

resident stop and chop title

We did a survey recently and about 20% of our viewers indicated that they wanted more videos of novice surgeons who are still learning basic techniques of cataract surgery. Today’s video is a young surgeon who has only done about 30 cataract surgeries on his own and he is doing phaco stop-and-chop for nucleus removal.

The surgery is quite good for an ophthalmologist who is so early in the learning curve of phacoemulsification, but there are a few areas that could use refinement.

The excellent parts of the surgery are:

  • good draping and patient anesthesia
  • properly constructed incisions
  • excellent capsulorhexis and hydro-dissection
  • good ability to pivot within the incision and keep eye in primary
  • stop-and-chop technique is done very well
  • cortex removal is good and thorough
  • IOL is loaded well and centered in capsular bag

So much of the surgery is excellent, that we have just a few suggested areas of improvement:

  • since a cohesive OVD is used for the capsulorhexis, coating the corneal endothelium with dispersive OVD prior to inserting the phaco probe is recommended
  • allow the IOL haptics to unfold with the eye full of OVD instead of having the cold water from the I/A probe cause the lens to become less flexible
  • hydrate the incision in a linear manner at the corneal stroma to avoid having the two corners of the incision sealed while the central incision is not hydrated

This resident is sure to become a very talented surgeon and I look forward to operating with him over the course of the next year.

Click below to learn from the Beginning Surgeon Stop-and-Chop Case (16 min):

All content is © 2018 by Uday Devgan MD. All rights reserved.



  1. Do you have any tips for adaptation from superior to temporal incision? It Feels like that the forehead gives more stability when doing superior incisions.

    1. You can do both superior and temporal incisions. For temporal, the eye will have a greater range of movement so pivoting in the incision and keeping the eye in primary position are important.

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