Last week we featured a video of me performing flip and chop on a cataract of modest nuclear density, so it begs the question: Can we perform flip and chop on a nucleus with more density? This variation of phacoemulsification is great for efficient removal of dense cataracts. After creating a 5.5 mm capsulorhexis, we use gentle hydrodissection to lift one pole of the nucleus out of the capsular bag into the anterior chamber, a maneuver termed the “flip.” This exposes the posterior aspect of the nucleus, allowing direct chopping with a second instrument to split the nucleus into manageable fragments. By flipping the nucleus into the iris plane, the technique minimizes stress on the zonules and posterior capsule, making it particularly useful in hard nuclei. Efficient debulking and removal of nuclear fragments follow with high vacuum and controlled phaco power. The technique enhances safety and control in dense cataracts while preserving capsular integrity for intraocular lens implantation. Have you tried this technique yet?
Hi Dr. Devgan,
Can you please comment on the capsule integrity if you do this with a dense lens? Have you noticed anterior capsule tear with this technique with a denser lens?
Thank you
You need a sufficiently large capsulorhexis (5 to 5.5mm) with a denser nucleus. I have not noticed these capsular tears. I have many, many videos of flip and chop here on CataractCoach.com — see the search box below.
thank you, will do!