Abstract
The stop-and-chop technique, which involves occlusion and chopping using vacuum to stabilize the nucleus, is an excellent combination of the divide-and-conquer and phaco-chop techniques. However, effectively chopping an un-solid (soft to moderate) nucleus is not easy, since the optimal vacuum to hold an un-solid nucleus is often associated with breaking of occlusion and aspiration of the nucleus. We modified the stop-and-chop technique such that occlusion and tight nucleus holding using ultrasound (US) power is not necessary. After completing the central groove and cracking the nucleus into two hemi-sections, the right nucleus half is chopped without nucleus rotation and occlusion. The right hemi-nucleus is stabilized by pressing against the right sac with the US tip without occlusion. Since this technique can reduce the risk of nucleus perforation and posterior capsular rupture, the surgeons can place the US tip firmly in a deep position, which provide safe and efficient nucleus division.