This video shows something that I have never previously seen before: removal of the lens cortex prior to removing three of the nuclear quadrants. Our guest surgeon is Dr Gary Wörtz from Kentucky, USA and his patient is moving a lot during cataract surgery. When this happens there is a risk of inadvertently damaging the capsular bag. After removing one quadrant of the nucleus, he now has sufficient access to remove the lens cortex. And then after removing two of the nuclear quadrants, he leaves the last one in the anterior chamber and inserts the IOL first in order to further protect the posterior capsule. And finally, there is one more pearl: he shows us a technique for making a hydration pocket above his main incision in order to seal it.