When performing any nucleo-fractis technique, it is imperative that the nucleus be completely subdivided prior to removing the halves, quadrants, or fragments. If the split is incomplete, then it becomes difficult to bring the first piece of the nucleus out of the capsular bag and into the iris plane for emulsification and aspiration.
In this case, the phaco chop technique succeeds in splitting the nucleus and achieving a cleavage plane down the center of the cataract. However, there is an area of incomplete separation of the two hemi-nuclear pieces and this will pose an issue when trying to bring the pieces up and out of the capsular bag.
The solution is simple: use the chopper and the phaco probe to help propagate the crack throughout the nucleus and push apart the two halves until they are separated completely.
Click below to learn this important maneuver for using during phaco chop:
