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Iqbal "Ike" K. Ahmed, MD, FRCSC
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This is my go-to cataract surgery technique for dense cataracts where predictability of cracking can be a challenge. I love phaco chop but these thick dense lenses don't always crack fully. Stop and chop by grooving a full-length groove and then cracking is a good alternative but requires excessive sculpting. So I use sculpt mode to dig a deep trench (debulk) down to the posterior pole. This makes cracking more predictable through the thinned posterior plate. Then, using longitudinal phaco and high vacuum to lollipop the remaining handle, I chop and use lateral separation to propagate the crack. Torsional phaco with increased flow rate allows for enhanced followability to remove chopped segments.
Posted: 8/14/2020
Iqbal "Ike" K. Ahmed, MD, FRCSC
This is my go-to cataract surgery technique for dense cataracts where predictability of cracking can be a challenge. I love phaco chop but these thick dense lenses don't always crack fully. Stop and chop by grooving a full-length groove and then cracking is a good alternative but requires excessive sculpting. So I use sculpt mode to dig a deep trench (debulk) down to the posterior pole. This makes cracking more predictable through the thinned posterior plate. Then, using longitudinal phaco and high vacuum to lollipop the remaining handle, I chop and use lateral separation to propagate the crack. Torsional phaco with increased flow rate allows for enhanced followability to remove chopped segments.
Posted: 8/14/2020
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