When you sculpt grooves for divide and conquer you are phacoemulsifying the same mass and volume of cataract that you would after chopping. I'm not sure phaco chop reduces the amount of phaco energy. You still have to phacoemulsify the entire volume and mass of the lens nucleus. Now if you sculpt by thin shaving rather than fully occluding the tip then yes, D and C will take more energy. But there is a way to make the grooves with a fully or nearly fully occluded phaco tip. I use a kind of hybrid divide/ chop for most cats.
get a patient with similar cataracts in both eyes. Do divide and conquer in one eye and phaco chop in the other. Now look at the cumulative dissipated energy (CDE) for each. Phaco chop uses significantly less ultrasonic energy!
thank you sir for this video. I'm also trying to learn phacochop. I am using a centurion with these parameters: IOP 65 Vaccum 500 and asp flow at 37, all on the same level. i can't keep the cataract in the phaco prob when trying to chop it. I lose it quickly. should the asp flow be reduced? or should it be gradual? what are your parameters for phacochop? thank again sir
A resident with “only a couple hundred cases”-I only got 80 cases before graduation!
that is ok, young jedi. just keep learning from CataractCoach.com and you will be fine!
When you sculpt grooves for divide and conquer you are phacoemulsifying the same mass and volume of cataract that you would after chopping. I'm not sure phaco chop reduces the amount of phaco energy. You still have to phacoemulsify the entire volume and mass of the lens nucleus. Now if you sculpt by thin shaving rather than fully occluding the tip then yes, D and C will take more energy. But there is a way to make the grooves with a fully or nearly fully occluded phaco tip. I use a kind of hybrid divide/ chop for most cats.
get a patient with similar cataracts in both eyes. Do divide and conquer in one eye and phaco chop in the other. Now look at the cumulative dissipated energy (CDE) for each. Phaco chop uses significantly less ultrasonic energy!
@@UdayDevgan Ok I’ll do it, thanks. I was thinking about it theoretically…
@@mguerramd also look up in medline -- published reviews compare the two techniques
thank you sir for this video. I'm also trying to learn phacochop. I am using a centurion with these parameters: IOP 65 Vaccum 500 and asp flow at 37, all on the same level. i can't keep the cataract in the phaco prob when trying to chop it. I lose it quickly. should the asp flow be reduced? or should it be gradual? what are your parameters for phacochop? thank again sir
See here:
cataractcoach.com/category/phaco-fundamentals/
That will help you a lot
Thank you so much Sir. I just want to reassure myself about your voice. An ENT consultation please.
Very nice surgery and hand skills . Is it better that IOL haptics be in reverse S shape ? I think the IOL was S shaped in this video ?
re-watch it -- it is in the correct (anti-S) orientation
Uday Devgan sorry, I watched it again and you are right . Thank you