In dense white cataracts, the vertical chop technique is highly effective because it utilizes shearing forces rather than the compressive forces seen in horizontal chop. This is critical for leathery, brunescent nuclei that often lack an epinuclear cushion. To begin, the phaco tip is deeply impaled into the central nucleus using high vacuum to gain a firm “purchase.” A sharp vertical chopper is then driven downward into the nucleus just anterior to the phaco tip. The surgeon then moves the two instruments apart laterally, propagating a fracture through the entire nuclear thickness, including the stubborn posterior plate. This “in-situ” fragmentation minimizes zonular stress and reduces total ultrasound energy, protecting the corneal endothelium. By keeping maneuvers within the central pupillary zone, the surgeon avoids the risks of blindly placing a chopper behind the iris in eyes with poor red reflex.
