Our anonymous resident is performing case 120 and is doing a great job. For a beginning surgeon learning the divide and conquer technique, start by creating a well-centered, continuous curvilinear capsulorhexis of about 5–5.5 mm to ensure safe nuclear division. Perform thorough hydrodissection to separate the cortex from the capsule, allowing the nucleus to rotate freely. Next, sculpt a deep central groove in the nucleus using low vacuum and moderate ultrasound power, aiming for about two-thirds of its thickness. Then, carefully crack the nucleus into two halves by gently applying lateral pressure with the chopper and the phaco probe. Once divided, rotate each half and repeat grooving and cracking to further segment the nucleus into manageable pieces. Use low flow and low vacuum settings to maintain chamber stability throughout. Aspirate each fragment safely, keeping the phaco tip in the center of the groove to avoid stressing the capsule or zonules. Patience and controlled movements are key to minimizing complications and building confidence.
