Comparing phaco tips

Phaco chop technique

There are many variations of the chopping technique described in the literature, however, Dr Bazzigaluppi noted that his preference is the vertical chopping technique. In this form of the technique the chopper and phaco tip induce the fracture to the lens by moving together in the vertical plane. "I use the vertical chopper like a spike to impale downward into the nucleus just anterior to the centrally buried phaco tip," he said. "This action creates the fracture line that is propagated further posteriorly when the embedded instrument tips are moved apart. Common to all vertical chopper designs is a short, but sharpened tip that is able to penetrate the nucleus."

He explained that key to a successful vertical chop is impaling the tip as deeply into the central nucleus as is possible, so that there is sufficient grip to be able to lift the nucleus upward. "By immobilizing the nucleus against the incoming sharp chopper tip, enough shearing force is generated to fracture the material," Dr Bazzigaluppi stated.

Additionally, a high vacuum is invaluable for the vertical chopping technique where a strong purchase is required. "With brunescent lenses," continued Dr Bazzigaluppi, "burst mode helps to maintain a tight seal around the phaco tip, which is a prerequisite for accessing high vacuum."