the hemi-nucleus tuck technique

One of the challenges in phaco surgery is that we need to break up the nucleus in order to remove it from the capsular bag. The typical capsulorhexis is about 5 mm in diameter while the average cataractous nucleus is 9 mm in diameter. For this reason, most surgeons split the nucleus into quarters or smaller fragments before pulling them out of the capsular bag.

Using the technique of the hemi-nucleus tuck, we can simply split the nucleus into two halves and each piece can then be removed through the capsulorhexis. The tuck refers to using the chopper to hold, pull, and tuck the proximal hemi-nucleus to create more space so that the phaco probe can bring the other hemi-nucleus out of the capsular bag. This really facilitates cataract surgery and makes it more efficient. For a typical cataract of 2+ to 3+ nuclear sclerosis, this is my preferred technique, whereas I may do further sub-chopping in the capsular bag for a 4+ dense nuclear cataract.

Click below to learn this technique and improve your surgical efficiency: