Review: 4 quadrant chop-and-conquer

Many ophthalmologists in training start out by learning the four quadrant divide-and-conquer technique, which has a long history of being a safe and reliable technique. The downside with this technique is that it requires a lot of ultrasonic energy to sculpt the grooves in the nucleus and it is not as efficient as the phaco chop technique.

The four quadrant chop and conquer technique is simply a play on words to explain that we can achieve the same goal of divide-and-conquer, producing 4 nuclear quadrants, with more efficiency and a higher degree of safety by using a quick chop technique. The safety is higher because there is less ultrasonic energy (gentler to the corneal endothelium) and we stay away from the posterior capsule (compared to grooving deep trenches within the nucleus in closer proximity to the posterior capsule).

Watch the video and then ask yourself, which technique would you rather perform? And which technique would you want done to your own eyes if you were the patient? I think the answer will be phaco chop.

Upgrade from the divide-and-conquer technique. Take the time to learn phaco chop — it is not easy to learn, but with time, you will certainly be able to master it. Diligence, drive, and determination are the keys to success.

Click below for the video of four quadrant chop-and-conquer phaco surgery:

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