Prof.Ajay Dudani

Dr. ANJALI ISRANI, Dr. ANJALI ISRANI, Dr.Hema. M. Mer

Abstract

Phacoemulsification in a rock hard nucleus is challenging, even for experienced surgeon. Incidence of capsular-zonular complications, corneal edema wound burn and post-operative inflammation are high. However, surgeon can achieve gratifying results if a proper and effective surgical strategy is adopted.After a careful capsulorrhexis, gentle hydrodissection is done to detach the hard nucleus. A small, eccentric, vertical trench is made by placing the probe in the center and beginning the trench from the center like drawing a radius. This radius is eccentric as we want to divide nucleus into inequal halves. Without cracking, this nucleus is rotated 180 and in “chop” mode, using starting point of trench as “chop-wall”, an attempt to chop smaller half is made. Because of trench behind, this smaller half easily cracks and emulsifies. Once the smaller half is emulsified, there is lot more space in the bag for the bigger half for emulsification. this known as half cut, half chop method.