Phaco tip-chopper flip technique for epinucleus removal in cataract surgery.

PURPOSE: To introduce the Phaco Tip-Chopper Flip Technique in removing epinucleus during phacoemulsification, and to report the preliminary clinical outcomes in patients who underwent this technique.

METHODS

Sixteen eyes with various conditions that underwent the Phaco Tip-Chopper Flip technique were retrospectively reviewed. The key steps of this technique consisted of retaining the phaco tip in the irrigation/aspiration (I/A) mode after nuclear fragment removal, using low-to-moderate vacuum to aspirate the folded portion of the epinucleus while the chopper was used to push the interior edge. The coordinated application of these forces flipped the epinucleus away from the capsular bag, enabling its rapid removal.

RESULTS

All surgeries were completed successfully without any intraoperative or postoperative complications, notably without posterior capsule rupture. Thick and adherent epinucleus was smoothly aspirated in the vast majority of cases under I/A mode using a high vacuum (400 mmHg). Postoperative corrected distance visual acuity improved as expected in all cases at both 1-day and 1-week follow-ups.

CONCLUSION

The Phaco Tip-Chopper Flip Technique appears to be a safe and efficient method for epinucleus removal based on this preliminary experience, and is suitable for various types of cataract scenarios.