You know that I’m a big fan of the phaco chop technique for nucleus disassembly during cataract surgery because it … More
Category: Phaco Chop
1039: complete case: surgeon control
This is a complete cataract case, shown from start to finish, with me as the surgeon. While many of the … More
1019: from one chop to the next
This complete cataract case shows how we move from the first chop to the next in order to efficiently break … More
1017: complete case with dense endo-nucleus
This complete cataract cases features a younger patient who developed bilateral cataracts with a dense endo-nucleus. We also implant a … More
1012: Resident White Cataract Chop
The drive to continually improve our surgical skills starts in residency and then continues for the rest of our careers. … More
1008: Horizontal Chop Technique
Our guest surgeon is Dr Hafidi Zouheir from Rabat, Morocco and he expertly demonstrates the horizontal chop technique for a … More
highly myopic cataract surgery
These are some of the most rewarding cataract surgeries to perform since we can correct the cataract as well as … More
Simplified Pre-Chop Technique
The pre-chop technique refers to mechanically breaking the nucleus into smaller pieces prior to inserting the phaco probe into the … More
The critical step after the chop
There is a critical step after the chop that is absolutely required to facilitate nucleus removal. And this step is … More
Soft Chop technique for soft cataracts
With the amazing results from modern day cataract surgery, many patients are electing to experience the benefits of pseudophakia when … More
complete cataract case: optimize steps
Most of us will have the opportunity to perform thousands of cataract surgeries (often tens of thousands) during the course … More
complete case: chop nucleus in the bag
One of my favorite types of videos to watch is the Complete Cataract Case. I enjoy seeing a surgery from … More
You don’t always need rings or iris hooks
For a case like this, there is no need for a pupil expansion ring or iris hooks. These devices can … More
Femtosecond Laser White Cataract
Our guest surgeon today is Xiongfei Liu MD from Sacramento, California. He was previously a resident with us at our … More
Complete Case: Pseudo-Exfoliation
Time for a complete cataract case, shown from start to finish. This patient has significant pseudo-exfoliation syndrome with all of … More
Phaco tip bevel down for chop
Many viewers of CataractCoach.com ask me why I prefer to have the phaco tip bevel down for cataract surgery. The … More
Secret to Chopping a Soft Cataract
If the cataract has a minimal amount of nuclear sclerosis, it is more challenging to chop it. The nucleus is … More
Complete Case: Propagate the Chop
Another video in our Complete Cataract Case series where we show you an entire surgery from start to finish. This … More
White Cataract Double Capsulorhexis
It is always a pleasure to learn from a master surgeon like Dr Pradip Mohanta from West Bengal, India. He … More
Playlist: Stop-and-Chop Technique
If you are currently performing the Divide-and-Conquer technique of nuclear division, then moving to the Stop-and-Chop technique is relatively easy. … More
complete case: phaco chop in myope
Complete Cataract Cases are videos where we show the entire surgery, from the first incision (usually the paracentesis in my … More
Learning Phaco Chop: you can do it!
Young surgeons need to learn to perform phaco chop — it makes cataract surgery efficient and increases safety. Less ultrasonic … More
Small Capsulorhexis Phaco Chop
The capsulorhexis is an important part of cataract surgery and one reason is that it allows access to the inside … More
Complete Cataract Case: Routine Surgery
While it is fun to watch a video of a cataract surgery that involves complicated maneuvers and difficult challenges, this … More
Rotary Chop Technique
The key to splitting a brunescent cataract is to access the central endo-nucleus. This is the densest part of the … More
Phaco Chop without Vacuum
It is a pleasure to watch an expert surgeon doing cataract surgery and I really enjoyed learning from Dr. Alex … More
Drill and Chop Technique
With a dense cataract, more effort and force is needed to chop the cataract. Usually with phaco chop, it is … More
complete cataract case: great red reflex
We all love a great red reflex during cataract surgery because it makes is much easier to see details such … More
Lateral Phaco Chop Technqiue
With traditional phaco chop, we place the chopper in front of the phaco probe tip, but there are other options. … More
Review: 4 quadrant chop-and-conquer
Many ophthalmologists in training start out by learning the four quadrant divide-and-conquer technique, which has a long history of being a … More
Resident Case: improve white cataract chop
In this anonymous video from a resident in Germany, we look to improve the horizontal chop technique in a dense … More
Resident Case: improve tilt and chop
In this anonymous video from a resident in Argentina, we look to improve the tilt and chop technique. This young … More
Resident Case: improve vertical chop
In this anonymous video from a resident in India, we look to improve the vertical chop technique. This young surgeon … More
Resident Case: improve horizontal chop
In this anonymous video from a registrar (resident) in the UK, we look to improve the horizontal chop technique. This … More
Expert Surgeon versus The Rock
There is so much to be learned by watching other surgeons operate. Even after so many thousands of cataract surgeries … More
Review: Slow Motion Phaco Chop
In the course of giving lectures across the USA and around the world, I meet many experienced ophthalmologists who find … More
Dense Cataract Vertical Chop
For a dense cataract, the vertical chop technique works well because the chop will propagate through the nucleus. We have … More
Submarine Chop for dense cataracts
For a dense cataract, performing phaco chop is challenging because the central lens nucleus is so hard that the chop … More
Complete Cataract Case: a very special case
This is a complete cataract case, shown from the making of the first incision to the sealing of the incision. … More
Fluidic Analysis during Phaco Chop
It can be helpful to see the machine fluidic parameters in real-time as the phaco chop procedure is performed. We … More
Complete Case: a very special patient
As a surgeon, it is always an honor when a colleague trusts you to operate on his eyes or on … More
Complete Case: vertical phaco chop
Another complete cataract case, this time showing the vertical chop technique to split the cataract into two halves. This is … More
Complete Case: Efficient Phaco Chop
Another great video in our series of Complete Cataract Cases. You’ll be able to learn from the very first incision … More
Pre-Chop with just 2 Choppers
Guest surgeon Dr Valentin Apostolov from Amsterdam shows us his technique for splitting a dense nucleus into small fragments before … More
Complete Case: PXF supra-capsular chop
The previous case (reference 611) from yesterday, showed the first eye of this patient where the technique was phaco chop … More
Complete Case: PXF chop in the bag
Today (video 611) and tomorrow (video 616) are the two eyes of the same patient who has pseudo-exfoliation syndrome and … More
Hydro-delineation makes chopping easier
Performing hydro-delineation helps to separate the denser, central endo-nucleus from the softer epi-nuclear shell. This endo-nucleus is smaller in diameter, … More
Show me a beautiful cataract surgery
Here on CataractCoach.com we have hundreds of teaching videos, and many of them are of very complex or complicated cases … More
Review: Embed the phaco tip without ultrasound
This review is particularly important for ophthalmologists who do cataract surgery for patients with mild to moderate nuclear density. This … More
Pre-Chop Variations for Cataract Surgery
In this video, submitted by Dr. Yaun Lin from Casablanca, Morocco, we can learn multiple different variations of Pre-Chop. This … More
Benchmark: Senior Resident Chop
This is a good benchmark for what a senior resident should be able to achieve by the end of residency … More
Seems like a good chop but…
Another video for our series of Complete Cataract Cases, we present a surgery of me operating. During this surgery, I … More
Secret to Chopping Dense Cataracts
For the phaco chop technique, the nucleus is held stationary by the vacuum level of the phaco probe. This is … More
Pit Technique for Dense Cataracts
With a dense cataract, there can be a fibrous posterior aspect of the lens nucleus which makes chopping more difficult. … More
Review: Why is Phaco Chop not working?
This patient certainly needs cataract surgery because the dense nucleus has a large degree of central opacity and that has … More
The Chopper Push Technique
Watch this video carefully and you will see that the chopper instrument is used just once to create a single … More
Complete Case: Chop in the Bag
Again we have a complete case, from start to finish, showing a routine cataract surgery with a phaco chop technique. … More
You must learn this before finishing residency
The challenge of residency training is that you have just a limited time to learn surgery. You can read books … More
Complete Case: Flomax & Toric IOL
Many of our CataractCoach.com readers have been asking for complete cases, shown from start to finish. There is a lot … More
Cataract Quiz: The chop failed. Now what?
Even for expert cataract surgeons, sometimes the attempt at phaco chop fails. This can be due to many reasons and … More
Trap a dense nucleus in order to chop it
With a very dense and fibrous cataract, using just the vacuum from the phaco tip to hold the nucleus is … More
Phaco Chop in patients over age 90
In previous videos we have explained the differences when operating on nonagenarian patients. These patients have weaker tissues such as … More
Complete Case: Brunescent & White Cataract
This patient truly needs our help. She developed a cataract in the right eye a few years ago and was … More
Review: Side View of Hand Position
While we do hold the phaco probe with a pencil grip, we do not use the same angle as writing with … More
Trouble learning phaco chop? Try this first
One of the main reasons why phaco chop is more difficult to learn than divide-and-conquer is that there is a … More
Struggling with Phaco Chop? Let me help you
I will be the first to tell you that mastering phaco chop is not easy, but it is certainly worth … More
How far do you insert the Chopper for Phaco Chop?
A young surgeon who is new to phaco chop asked me how deep to insert the chopper tip into the … More
Resident Surgeon Learning to do Phaco Chop
In your quest to learn phaco chop, it is helpful to watch other beginning surgeons perform the same technique. In … More
Highly Efficient Stop-and-Chop
From watching videos here on CataractCoach.com, you’re aware that my favorite method of nucleus division is phaco chop. Any form … More
Review: External View of Phaco Chop
Most of the videos on this site are taken through the operating microscope. This gives the view of exactly what … More
The chop failed, so I reverted back to this…
The benefit of learning many different phaco techniques is that you can choose the one that is best for each … More
Learning Vertical Chop
Vertical chop means that both the phaco probe and the chopper are placed within the capsulorhexis and then both are … More
Slow Motion Phaco Chop
In the course of giving lectures across the USA and around the world, I meet many experienced ophthalmologists who find … More
Guest Surgeon Phaco Chop Technique
One of the hallmarks of a good surgeon is the ability to learn from other surgeons. In this case we … More
Mastering Divide-and-Conquer Phaco
Back by popular demand! Most beginning surgeons start by learning divide-and-conquer as the primary method of nucleus division for cataract … More
Quiz: Why is this phaco chop going to fail?
Look at this photo carefully. We can tell that this phaco chop will fail and the nucleus will not be … More
Cataract Surgery in a 100-year-old patient
We should all be so lucky to live to 100 years old. It’s quite a rarity and it is something … More
Cataract Surgery after Corneal Transplant
Cataract surgery in an eye with a prior corneal transplant is more difficult and there are challenges which can alter … More
Phaco Chop in the bag with smaller pupils
In many of the prior videos related to smaller pupils, I have emphasized the technique of bringing the nucleus partially … More
Guest Surgeon “Submarine Chop”
We all learn from each other and today’s video is a great example of that. We are learning from Dr. … More
Cataract Surgery prior to Glaucoma Surgery
We know that this patient will be undergoing glaucoma surgery in the near future and you are doing the cataract … More
Review: Learn Horizontal Phaco Chop
The original phaco chop technique described by Dr. Nagahara in 1995 was the horizontal chop. This involves holding the lens … More
Evaluation of a resident chop technique
This video was submitted by a resident in Asia who is still learning phaco and has upgraded to using the … More
Guest Surgeon: Phaco Chop Technique
This video was anonymously submitted by an experienced surgeon who wants us to analyze the phaco chop technique and give … More
Pre-Chopper Phaco Technique
There are many different ways to divide the nucleus during cataract surgery. Phaco of smaller nuclear fragments is easier and … More
Use the Chopper to Lift Nuclear Pieces Up
In cases where the capsulorhexis is small or where the nucleus is particularly large, it can be difficult to bring … More
Review: Embed the phaco probe without ultrasound
The classic teaching for phaco chop and quadrant removal is to embed the phaco probe into the nuclear piece by … More
Phaco Chop without using the phaco probe
This is a cataract surgery performed by a resident in training and the patient is known to have Fuchs’ corneal … More
Achieving a complete hemi-nuclear split
When performing any nucleo-fractis technique, it is imperative that the nucleus be completely subdivided prior to removing the halves, quadrants, … More
Quiz: For a pupil like this, what is your approach?
With time, young ophthalmologists develop surgical judgment and they are able to look at a case and decide what approach … More
Phaco Flip & Chop is great for Beverly Hills Cataracts
Often, the density of the nucleus and the severity of the cataract relates to the patient’s access to healthcare. In … More
Review: if the chop fails, revert to stop and chop
Sometimes we attempt to use phaco chop to divide the cataract nucleus, but we are just not able to achieve … More
Should we chop in the bag or above the bag?
Should we chop the nucleus within the capsular bag or should we bring the nucleus partially out of the capsular … More
The Chop will not propagate through the cataract
With a dense cataract, a fibrous posterior plate can develop within the lens nucleus. This makes is challenging to split … More
Vertical Chop & Horizontal Chop in the same case
Phaco chop is my preferred method of nucleo-fractis for cataract surgery. It is safe, efficient, and minimally invasive, significantly reducing … More
Tilt and Chop – a SupraCapsular Technique
Supracapsular phaco techniques are in closer proximity to the corneal endothelium, which can be damaged by the ultrasonic energy from … More
SupraCapsular Technique for Softer Nuclei
For a relatively soft nucleus, such as in a younger patient with primarily posterior subcapsular cataract changes, the supracapsular technique … More
Removing the last nuclear piece
When we break the cataract nucleus into smaller fragments, we can sometimes have one of these small pieces stuck in … More
Understanding Force Directions in Phaco Chop
Many resident surgeons find it challenging to learn the technique of phaco chop because of the force vectors which are … More
Adjust the Phaco Probe Angle during Chop
The phaco probe angle changes during the procedure. When we embed the phaco tip into the nucleus, the probe is … More
Review: Beginning Surgeon Learns Phaco Chop
You’ve seen countless videos of phaco chop, but you seem to be stuck in a mode of less efficient techniques … More
Side View shows the Phaco Probe at a flat angle
While we do hold the phaco probe with a pencil grip, we do not use the same angle as writing … More
Foot Pedal Position during Phaco Chop
Learning phaco chop will make your cataract surgeries safer, more efficient, and more enjoyable to perform. And of course, phaco … More
Foot Pedal Positions for Learning Phaco Chop
Cataract surgery requires both hands and both feet of the surgeon in order to perform the modern techniques. It seems … More
Use the chopper to protect the capsular bag during phaco
The chopper can do so much more than just divide the nucleus into pieces. The chopper can fixate the eye, … More
Review: Solution for the Dense Nuclear Posterior Plate
Looking at this image should intimidate beginning cataract surgeons: this is a whitish-brown totally opaque cataract and it is a … More
The Chop failed because the nuclear halves did not separate
The phaco chop technique is like splitting firewood: the instrument creates the initial cleavage plane which then must be propagated … More
Review: Fully Separate Nucleus after the Phaco Chop
When doing phaco chop, remember that you must still physically push apart the nuclear halves to achieve complete separation and … More
Guest Surgeon: The UltraChopper for Dense Cataracts
Professor Luis Escaf from Barranquilla, Colombia presents a case here of a dense cataract with a small pupil. He uses … More
Review: Multiple Small Chops for a Dense Cataract
In previous videos, I have shown my technique for breaking up a dense brunescent cataract with a fibrous and tough … More
I just cannot chop this cataract – you’ll never guess why!
This seemed like a routine cataract surgery, but I was wrong. I just could not seem to chop this cataract … More
Review: Four Quadrant Chop-and-Conquer
The idea behind divide-and-conquer makes a lot of sense: divide the nucleus into four quadrants which are more easily phaco-aspirated … More
Review: Cracking the Posterior Plate in a Dense Cataract
With a dense brunescent cataract, one of the primary challenges is cracking the fibrous posterior plate of the nucleus. Using … More
Embed the phaco probe in the nucleus without ultrasound
The classic teaching for phaco chop and quadrant removal is to embed the phaco probe into the nuclear piece by … More
Chopper placement is critical to nucleus division
The placement of the chopper is critically important to achieving division of the cataract nucleus with the phaco chop technique. … More
If your Phaco Chop fails, simply revert to Stop-and-Chop
Sometimes we attempt to use phaco chop to divide the cataract nucleus, but we are just not able to achieve … More
The incision and capsulorhexis are your signature
I like to think of the phaco incision and the capsulorhexis as my “signature” on every cataract surgery that I … More
Probe Placement to Facilitate Phaco Chop
Placement of the phaco probe and the chopper are critical to facilitating the phaco chop procedure. One of the big … More
Flip and Chop Phaco is Ideal for Routine Cases
The flip and chop phaco technique has been presented here before on many occasions because it is such an efficient … More
Use the Chopper to Push Nuclear Pieces to the Probe
The chopper is used for many different functions during cataract surgery, beyond just chopping the nucleus into smaller fragments. Cataract … More
What beginner mistakes do you see in this pic?
Learning intra-ocular surgery is not easy and it can take years just to be comfortable with just the basics. Look … More
Resident Surgeon Struggles with Phaco Chop
In this anonymous video, a resident surgeon struggles with phaco chop. It is not an easy technique to learn, which … More
Beginning Surgeon Learns Phaco Chop – so can you!
You’ve seen countless videos of phaco chop, but you seem to be stuck in a mode of less efficient techniques … More
Expert Technique: Small Pupil & Dense Cataract
Very experienced surgeons never rest — they are always looking to learn more. Like you, I learn a lot from … More
After the chop, you must physically separate the nucleus
When doing phaco chop, remember that you must still physically push apart the nuclear halves to achieve complete separation and … More
Pre-Chop the Nucleus to Help a Novice Surgeon
Today we have a video of a novice surgeon operating together with an experienced surgeon. The key maneuver in this … More
How to Split the Cataract if the Chop is incomplete
Sometimes when we perform phaco chop, the lens does not fully divide. The chop scores and partially splits the nucleus, … More
Complete Toric IOL Case: from Marking to Alignment
Toric IOLs allow us to surgically treat corneal astigmatism at the time of cataract surgery thereby providing our patients with … More
Horizontal Phaco Chop for Efficient Cataract Surgery
The original phaco chop technique described by Dr. Nagahara in 1995 was the horizontal chop. This involves holding the lens … More
Hydro-delineate if the Capsulorhexis appears small
In this picture, the capsulorhexis appears to be on the small side, but it is actually just about perfect with … More
Use Multiple Small Chops for a Brunescent Cataract
In previous videos, I have shown my technique for breaking up a dense brunescent cataract with a fibrous and tough … More
Phaco Chop with Surgeon-Loaded Toric IOL
Yesterday’s video was a complete toric IOL case from marking to alignment, however the IOL was loaded by the technician … More
Learning from an External View of Phaco Chop
Most of the videos on this site are taken through the operating microscope. This gives the view of exactly what … More
Persistence during Phaco Chop is critical
It is critical that you not give up on phaco chop as a technique but also within a surgical procedure. … More
Vertical Chop Technique for Efficient Surgery
The vertical chop technique is a favorite of mine, particularly when there is sufficient nuclear density to allow the chop … More
Switching from Vertical Chop to Horizontal Chop
Sometimes cataract surgery is like playing basketball or soccer: you know many different techniques and special moves, but the key … More
Use the Chopper for Hemi-Nucleus Management
The chopper can do so much more than chop. It can be used to fixate the eye via the paracentesis, … More
Four Quadrant Chop & Conquer Technique
Many ophthalmologists in training start out by learning the four quadrant divide-and-conquer technique, which has a long history of being … More
Why did this Phaco Chop fail to split the cataract?
In order to do a successful phaco chop, we need to make sure that the high vacuum level of the … More
Why you MUST learn Phaco-Chop (Resident Case)
A critical part of being an accomplished ophthalmologist is keeping up with the advances in your field. For cataract surgery, … More
Cracking the Posterior Plate in a Dense Cataract
With a dense brunescent cataract, one of the primary challenges is cracking the fibrous posterior plate of the nucleus. Using … More
Floppy Iris Syndrome with Phaco Chop
We have a fun case here: the patient has a long-time history of Flomax (tamsulosin) use which limits his pupil … More
One-Chop Technique for Phaco Surgery
For a cataract with moderate nuclear density, splitting the nucleus into two halves can be sufficient for removal with phacoemulsification. … More
Management of the Hemi-Nucleus in Cataract Surgery
Whether you do phaco chop or stop-and-chop, you will be left with two halves of the nucleus which then need … More
Lifting the nucleus up though a small pupil
Here at CataractCoach, we have featured videos showing how to hydro-dissect a nucleus up, out of the capsular bag and … More
Adapting your Phaco Chop Technique to each Eye
I encourage ophthalmologists in training to learn multiple different nucleo-fractis techniques so that they can tailor the cataract surgery to … More
Solution for Incomplete Phaco Chops
You’re an experienced phaco chop surgeon and you come across a case where you just cannot get the chop to … More
Routine Dense White Cataract Surgery
Finishing up our week of routine cataract cases, today we are reviewing dense white cataracts. In some parts of the … More
Routine Phaco Chop Cataract Surgery
Continuing with our series about routine cataract cases, today we present a routine phaco chop surgery. The cataract is chopped … More
Routine Flip-and-Chop Cataract Surgery
We have previously featured an instructional video for the Flip-and-Chop method of cataract surgery and there was a very strong … More