Pistachio Chop: A New Technique for Teaching Chop and Safer Approach

Purpose

To describe a new technique that can be safer approach for inexperienced phaco surgeons to master the chop technique. Pistachio chop is a new chop technique in that the partial superior cortex and epinucleus are aspirated by phacoemulsification (phaco), and with direct access to the central nucleus, which is adequately separated from the epinucleus by hydrodeliniation, the nucleus is chopped with the protection of inferior epinucleus. These separations help the surgeon to easily place the chopper deep into the body of the nucleus with better control and vision.

Observation

The patient in the technical video had a 3+ nuclear sclerosis cataract. The preoperative vision in this eye was 20/80, with no improvement with spectacle correction On postoperative day 1, visual acuity had improved to 20/40. By postoperative week 1, the best-corrected visual acuity was 20/20.

Conclusion and importance

This method avoids zonular stress. Additionally, inexperienced surgeons using this technique during cataract surgery can practice better the movements necessary for the chop technique in a safer environment.

 Electronic supplementary material

The online version of this article (https://youtu.be/Wg5gpubX584?si=Zd2zBVZRfzeCUXvc) contains supplementary material with surgical video of this technique.

Keywords: Cataract surgery, Chop, Phacoemulsification, Resident, Teaching phaco, Training