This video showcases the entire surgery which we are running at 2x speed so that it is just 5 minutes. That is 5 minutes of intense learning. The key in these cases is to crack the dense posterior plate of the nucleus. If we are going from the anterior lens surface such as routine vertical phaco chop, we may find that the chop will not fully propagate through nucleus. In the technique shown here, the chopper is placed behind the posterior aspect of the nucleus and in front of the posterior capsule. The nucleus is now trapped between the chopper and the phaco tip and a high degree of force can be applied to split the nucleus. This is better than using only vacuum holding power to fixate the nucleus. I wish patients like this would elect to have surgery at an earlier stage, before developing dense brunescent cataracts.
click to learn the key to phaco chop in dense brunescent cataracts: