CataractCoach™ 2653: soft cataracts versus hard cataracts скачать в хорошем качестве

CataractCoach™ 2653: soft cataracts versus hard cataracts

   / @pradipmohanta9321   Yesterday, our CataractCoach Podcast featured Dr Pradip Mohanta who has a YouTube channel where he teaches ophthalmic surgery. During our podcast we discussed helpful techniques for mastering cataract surgery with eyes having different grades of nuclear sclerosis, from soft to hard densities. This video shows his technique for these types of cataracts and is very useful to learn. When approaching cataract surgery, the choice of technique must be tailored to the lens consistency. In soft cataracts, particularly in younger patients, a pre-chop technique can be highly effective. Because the lens nucleus lacks density, traditional phaco energy may be unnecessary or even harmful. After completing capsulorhexis and hydrodissection, a pre-chopper instrument is introduced into the nucleus to mechanically divide the soft lens without phaco power. This method avoids the risk of thermal damage and minimizes endothelial trauma. Since the lens material is soft, it can often be aspirated with minimal phacoemulsification, using low vacuum and flow parameters to preserve anterior chamber stability and protect the posterior capsule. Gentle handling is essential to prevent capsular rupture, as soft nuclei do not resist instrument movement as much as denser lenses do. In contrast, dense cataracts require a more energy-efficient and mechanical approach. The submarine chop technique is particularly useful in these cases. After capsulorhexis and thorough hydrodissection, the phaco tip is buried deeply into the nucleus while still within the epinuclear shell—"submarine" under the surface—followed by a quick, forceful chop with the second instrument to divide the nucleus. This method minimizes stress on the zonules and reduces phaco time by creating early fragmentation. Emulsification is performed within the capsular bag, helping to contain energy and protect intraocular structures. Dense lenses require dispersive OVDs and careful modulation of energy to reduce endothelial cell loss and maximize safety.