Dr. RAVEENDRA T.

, Dr. LAKSHMI SHANMUGAVELU

Abstract

Complete nucleus fragmentation by chopping is critical for the subsequent safe movement of pieces during the fragment aspiration stage. Situations where the nucleus is harder or the pupil is smaller often leads to remaining posterior plates connecting the fragments, often in an occult manner, and can lead to difficult situations subsequently. The angulation at the tip of the bent Kelman (R) phaco tip allows an added dimension of force to be used, apart from that in a horizontal plane, that we use at the occlusion-to-hold-and-horizontally-separate into pieces; by adding controlled pronation to rotate and TWIST the phaco tip, the fragments move apart more and separation gets confirmed by more view of red glow. We demonstrate the utility of the Twister Chop in various grades of nucleus hardness and also in small pupil situations.