Authors: Troy Teeples, MSIV, Tara Hahn, MD, Nikko Ronquillo, MD, Jeff Pettey, MD
Photographer: Troy Teeples, MSIV University of Utah School of Medicine
Keywords/Main Subjects: Pre-chop, cataract surgery
Brief Description: Pre-chop is a technique used in cataract surgery to divide the lens without the use of ultrasonic energy.
Pre-chopping is a nuclear fragmentation technique implemented prior to phacoemulsification of the lens. Using a prechopper, the nucleus is divided typically into two to four pieces to help facilitate lens removal using phacoemulsification. The use of this technique decreases the use of ultrasonic energy and intraocular irrigation compared to other phacoemulsification division techniques such as divide-and-conquer.
Following routine hydrodissection, a small amount of viscoelastic is injected to aid in visualizing the anterior surface of the lens. Next, the Akahoshi prechopper instrument is introduced into the eye via the main clear corneal incision. The sharp point of the spatulated blades is entered into the center of the nucleus, following which the blades are slowly spread apart to divide the nucleus into two halves. As seen in the video, the surgeon may rotate the prechopper with the sharp end pointing away from the nucleus and repeat the spreading of the nuclear halves to ensure complete nuclear division. At this point the decision may be made to rotate the nucleus and further divide the nucleus into 4 quadrants using the prechopper or to proceed to phacoemulsification.
Faculty Approval by: Jeff Pettey, MD
Disclosure (Financial or other): None