Staying calm when you see danger signs

The second that I see this round hole, I know that it is a danger sign. We have previously explained the danger of the hole punch sign, and this round hole was certainly made by the tip of the phaco probe.

I am operating in this video and when I see this, my heart starts to race. What goes through my mind? How do I stay calm and do what is best for the patient? This is a video that you must watch!

click below to learn how to stay calm in the presence of a danger sign:


  1. Dear professor Uday
    Please when i started learning phaco chop, i faced the following difficulties
    1. When i tried to do the horizontal chopping the nucleus rotates and cant do chopping.
    2. When i tried to do the vertical chopping, unfortunately i couldnt embed the chopper at the nucleus?
    These are the settings
    1. Horizontal chopping:
    U/S power 50 ,linear mode
    Vaccum 50
    Flow rate 32
    Maximum flued level
    Fluid continuos.
    2. Same settings for vertical chopping
    That is why iam doing sculpting techiques since years

    So please what is your explanation for these difficulties
    Best regards

    1. sounds like you need much higher vacuum in order to hold the nucleus while you chop. Assuming a standard phaco tip size through a 2.75mm incision, you should have 300 to 400 mmHg of vacuum. Keep the flow rate of 32 cc/min and keep the high bottle height (infusion pressure).

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