Pop and Prechop - A Novel Safe Supracapsular Phacoemulsification Technique
As patients’ expectations, out-of-pocket expenses, and medicolegal liability have increased, it has become more and more difficult to find appropriate cases for trainee surgery. The published complication rates of capsular violation and vitreous loss for trainee-performed surgery ranges between 6% and 15%, which is unacceptably high. Christopher Starr, MD, presents the Pop and prechop technique, a modification of pop and chop which involves prolapsing or popping the lens out of the bag, engaging it en masse with the phaco handpiece, and dividing it using a traditional chopping maneuver at the iris plane. Pop and prechop was devised to make cataract removal easier, faster, and less complex for trainees.
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Comments (7)
Is it possible to use this technique , even in very hard nucleus,brown cataracts?nigra cataracts?
my technique for popping out of the bag is to hydrodissect towards my left and push down on the lens a little as the fluid wave goes across. only issue with this technique is that its nice to keep the rhexis at 5.5 for overlap on the iol, but thats a little too small for this technique, esp. with larger nuclei.
A nice video but I feel that the crucial point was glossed over ie: how to reliably express the nucleus out of the bag. Over the last 10 years I have taken pains not to have it inadvertantly pop out of the bag and consequently it almost never happens anymore. Therefore, it would seem that there would need to be some technique modification to effect a reliable pop-out every time.
I started using this type technique about 6 weeks ago. No capsular ruptures due to nucleus removal since. Try to keep the nucleus below th horizontal meridian. Any striae that form will not be in the optical axis. Postop VA is as good as Stop and Chop for me.
this is a good and not a new technique for soft nuclei does not work for old hard lenses
thank you for this pres., .. is it always possible to prolapse the lens out of the bag? Do you have some tips for this step of procedure?
Why use phaco at all? Just express the small fragments like an adapted Blumenthal technique.