With a dense cataract, a fibrous posterior plate can develop within the lens nucleus. This makes is challenging to split the cataract into smaller pieces for fragment removal phacoemulsification. In this case, the chopper is used to cleave the nucleus into two halves, but there is incomplete separating because the chop does not propagate completely through the cataract.
We have previously demonstrated different techniques of dealing with this situation such as brining the nucleus out of the capsular bag, In this case, we place the chopper around the lens equator and make many smaller chops in order to break pieces off the dense nucleus. After breaking off many smaller pieces, the remaining lens nucleus is more manageable and the case can be successfully completed.
click below to learn how to handle this tough situation: