If the cataract nucleus is more dense, such as 3-4+ NS, performing more chops is beneficial to break up the cataract into smaller pieces in order to use less phaco ultrasonic energy. In this case there is more nuclear density than the typical cataract and that means that even with a 5 to 5.5 mm diameter capsulorhexis, I should perform more chops in order to break the nucleus up into quadrants, sextants, or even small pieces. This complete cataract case shows the entire surgery from start to finish. I am sure that you will agree that is performed in an efficient manner and precise control and a large margin of safety. This is a benchmark that the hard working, diligent, and dedicated young surgeon can achieve with practice.
click to learn from this complete case where I perform multiple nuclear chops:
I enjoyed this series of different nuclear densities. Would you consider doing something similar reviewing your differences in settings for different nuclear densities? Or would you consider doing a similar series with the actual sound from the phaco machine during different densities of nuclear removal? I think either could have a ton of learning potential. Thank you for all you do.