Professor Luis Escaf from Barranquilla, Colombia presents a case here of a dense cataract with a small pupil. He uses his invention, the UltraChopper, which allows him to easily divide the nucleus into fragments. The UltraChopper consists of two parts: first a thin blade that attaches to the phaco handpiece and uses the ultrasound vibrations to help penetrate into the dense nucleus. Once the initial groove has been created with this device, a nucleus splitter with paddles is inserted into this groove and the nucleus can be fragmented. Surgeons can use this to divide the nucleus into 2, 4, or more segments which will simplify phacoemulsification.
I have not yet had the opportunity to try this device, but it looks like a good option for dense cataracts.
Click below to watch the ultrachopper in action: