Many viewers of CataractCoach.com ask me why I prefer to have the phaco tip bevel down for cataract surgery. The traditional teaching is bevel up because the tradition is sculpting a groove such as for the divide and conquer or stop and chop techniques. For phaco chop, we have a specific goal: to hold the nucleus with the phaco tip while the chopper splits the cataract into smaller pieces. This holding power requires the use of a high vacuum level, and with a peristaltic pump phaco machine, that means occluding the tip completely. This is much easier to do with the bevel down.
Click below to watch this video and learn why I prefer bevel down for phaco chop: