1590: flip & chop and clear corneas

This is a complete cataract case, shown start to finish, of a routine cataract surgery using the flip and chop technique. I have received many comments asking how the cornea can be clear on post-op day 1 and the viewers wondering if there is significant corneal endothelial cell loss. Let me first remind you that this is not anterior chamber phaco that was described decades ago and which caused a lot of PBK (pseuophakic bullous keratopathy). Look at the title photo and you will see that the nucleus has been only partially brought up, out of the capsular bag. Once the chop is completed and the nucleus is split into two halves, one half drops back in the capsular bag while the other half is partially in the bag and partially at the iris plane. We want to work at the iris plane while staying away from the corneal endothelial surface. This case is also highly efficient, with a bare minimum amount of ultrasonic power and fluidic currents placed in the anterior segment. The result is a perfectly clear cornea on post-op day 1. If you are trying flip and chop and the corneas are not clear on post-op day 1, then please learn from this video so that you find which steps need improvement.

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  1. Respected sir. I do flip and chop cases after seeing your video. But I use bevel up phaco probe not bevel down
    Technique which you describe. Post op day 1 i generally get some corneal oedema. I scare doing bevel down phaco as it may rupture Posterior capsule. Pls give ur expert comment sir

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