In this case the nucleus is chopped efficiently, but there is a struggle to bring up the first heminucleus. Why? … More
Category: Phaco Chop
1838: the easy way to learn phaco chop
There is some resistance among surgeons to learn a new technique because of the learning curve. For surgeons who are … More
1835: efficient phaco chop dense nucleus
This patient has a dense cataract — the kind where the posterior plate of the nucleus is tough and fibrous … More
1752: resident’s 3rd horizontal chop
Last week in video 1747, we showed you this same resident surgeon’s first case of horizontal chop and it went … More
1747: A resident’s first phaco chop case
The advantage of residency training is that a seasoned attending ophthalmologist is sitting right next to you, giving advice, teaching … More
1732: this white cataract is quite dense
We have previously explained that not all white cataracts are the same and that there is an entire spectrum of … More
1719: Crater Chop Technique
This resident cataract surgery case shows the crater chop technique where a central section of the nucleus is bowled out … More
1703: horizontal chop without vacuum
The traditional method of phaco chop uses vacuum holding power at the phaco tip to hold the nucleus while the … More
1693: curriculum lesson 13: phaco chop details
Merry Christmas to the young ophthalmologists who are going to make time to learn from this latest lesson in our … More
1679: Curriculum Lesson 12: more phaco chop
Phaco chop is such an important technique that we have another lesson going into more of the specifics. You can … More
1678: can you chop with any instrument?
I have said it before, the hands are more important than the equipment. And the technique is more important than … More
1665: Curriculum Lesson 11: basic phaco chop
Phaco chop is the most common nucleo-fractis technique among expert and master cataract surgeons because it is the most efficient … More
1611: dense cataract with foot pedal video
Surgeons who want to learn phaco chop sometimes have a challenge with the foot pedal control. When should energy be … More
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 … More
1565: hesitant to perform flip and chop?
Multiple CataractCoach.com subscribers have emailed me to ask for pearls for success with phaco flip and chop. They have some … More
1548: skill level after 2000 surgeries
We have previously discussed the surgical learning curve with a detailed explanation how the beginning part of the curve is … More
1544: the first chop didn’t work, so…
Enough resident cases for now. If you’re a novice surgeon who has enjoyed learning from the resident cases, you can … More
1534: a resident’s first phaco chop
We are in the middle of July and that means that ophthalmology residents in the USA are starting the academic … More
1519: tilt and chop is efficient and safe
This is a complete cataract case, shown start to finish, using the tilt and chop technique. This is like the … More
1501: complete toric IOL technique
Toric IOLs are great options to address corneal astigmatism, especially when it is 1 diopter or greater in magnitude. This … More
1487: dense central endo-nucleus
In this case, there was a dense central endo-nucleus that seemed somewhat resistant to chopping. When I chopped the nucleus, … More
1462: new graduate performs phaco chop
I am very proud of this young surgeon who is performing phaco chop for this routine cataract case. Let’s face … More
1442: this nucleus is denser than it looks
This is a complete cataract case, shown start to finish, of a patient seen in my private clinic. At the … More
1431: this is why I just need one chop
For routine cataract cases, I can perform just one phaco chop to split the nucleus into two halves and then … More
1430: mom of an ophthalmologist
Since our surgery center is in Beverly Hills, I have many celebrities as patients. Multiple actors / actresses who have … More
1399: four simultaneous camera angles
Our guest surgeon is Dr Andre Berger from Brazil and he is an accomplished, expert cataract surgeon. In this video … More
1378: young surgeon chop technique
The young surgeon featured in this video does an excellent job of performing phaco chop in this routine cataract case. … More
1360: cross chop technique
I enjoyed watching this video where our guest surgeon performs a technique that he calls swift chop. What’s interesting about … More
1354: phaco parameters for efficiency
Surgeons frequently ask me to list my phaco settings for performing efficient cataract surgery. Let me be the first to … More
1333: pre-chopper for nucleus division
The pre-chopper is an instrument with two blades which are shaped like paddles and they are embedded into the nucleus … More
1320: do I prefer flip or chop?
Many CataractCoach fans have emailed me asking which technique I prefer for routine cases: phaco flip or phaco chop? Some … More
1316: slow motion of combo phaco chop
This video features a combination phaco chop (a combination of vertical chop and horizontal chop techniques) where we play the … More
1311: routine case with moderate density
Don’t be fooled into thinking that there is not much to be learned from watching a routine cataract case. As … More
1298: cortical cleaving hydro-dissection
This video shows the technique of cortical cleaving hydro-dissection which we have previously covered. This involves using the fluid wave … More
1271: please steal this phaco technique
We all learn from each other — that’s one of the best things about ophthalmology. My surgical techniques are an … More
1263: double hook pre-chop technique
Our guest surgeon, Dr Érico Jun Oda from Brazil, does a great job with this surgery. Using just two hooks … More
1247: Bent Needle Pre-Chopper
Our guest surgeon, Val Apostolov MD, has been featured on CataractCoach many times before. He is an innovative surgeon who … More
1213: chop this dense cataract in the bag
This patient has a 4+ nuclear sclerotic cataract which we would classify as dense. Fortunately, it is not quite at … More
1187: don’t place the probe in the center
To achieve the best combo chop, you want to have a sufficient distance between the phaco probe and the chopper … More
1176: cataract surgery in Fuchs’ dystrophy
You will certainly encounter patients with Fuchs’ dystrophy where the corneal endothelial cell layer becomes compromised. With loss of endothelial … More
1175: the last case of residency
This is the final cataract case that was performed during residency and likely represents about 200 to 300 cataract surgeries … More
1169: surgery for a cataract surgeon
It is always a pleasure to do cataract surgery for a fellow cataract surgeon. This is the highest compliment that … More
1164: routine phaco chop complete case
From our Complete Cataract Case series, this is a video of a routine phaco chop case. It is not cherry … More
1158: adjusting the red reflex
The two primary illumination sources on your microscope are coaxial and paraxial. We have previously explained the differences in the … More
1131: Cataract Surgery in Ocular Albinism
Ocular albinism is rare, however just about every cataract surgeon will encounter at least one or two patients with this … More
1128: Why can’t I get the nuclear piece up?
You are ready for action. You embed the phaco probe and achieve high vacuum. You carefully place the chopper into … More
1123: dense brunescent cataract chop
This video showcases the entire surgery which we are running at 2x speed so that it is just 5 minutes. … More
1115: no need to hook the lens equator
The original technique of phaco chop involved placing the chopper under the capsulorhexis edge and then around the lens equator. … More
1110: more chops for a dense nucleus
If the cataract nucleus is more dense, such as 3-4+ NS, performing more chops is beneficial to break up the … More
1109: the mushy nucleus is tough to chop
Sometimes when we try to chop the nucleus, we realize that the cataract material is too mushy and the chopped … More