When a cataract is very soft, such as in a younger patient with a posterior sub-capsular cataract, we can prolapse the nucleus out of the capsular bag and use the phaco probe to easily and safely aspirate it. When a nucleus is denser, we can use nucleo-fractis techniques like phaco chop to split it into fragments which are then easily aspirated. But what about a case where the nucleus is soft and gummy? It is not so soft that we can prolapse and easily aspirate it and when we try to chop it, the gummy nature prevents the split of the nucleus. This video is a complete cataract case shown start to finish and you can learn my approach to successfully dealing with a soft and gummy cataract.
click to learn the techniques for a soft and gummy cataract:
After the initial incomplete chop, inject a dispersive viscoelastic into the crevice to complete the separation.