EW CATARACT
38
Furthermore, because anteri-
or chop is performed solely with
manual compressive forces, nuclear
fragmentation is consistently and
reliably achieved. These nuclear frag-
ments are likewise consistently and
reliably brought to the supracapsular
space using nuclear elevation—a
safe and easy manual alternative to
traditional vacuum purchase for soft
nuclear fragments (which may oth-
erwise adhere to the epinucleus or
disintegrate under low vacuum), as
well as dense fragments (which may
otherwise remain locked to neigh-
boring pieces like a jigsaw puzzle).
When employed with other chop-
ping techniques for fragmentation
of the proximal heminucleus, AC/
NE of the subincisional heminucleus
allows for minimal nuclear rotation.
This is beneficial in cases in which
lens rotation is not desired, such as
pseudoexfoliation and trauma, as
well as cases in which lens rotation
is not easily achieved, such as inade-
quate hydrodissection and posterior
polar cataracts.
AC/NE is a new, easy-to-learn
surgical technique that can be
employed by any anterior segment
surgeon. It can be performed with
existing equipment without reliance
on vacuum, ultrasound, or special
fluidics or power modulation, and
adds a considerable measure of
safety and efficiency to cataract
removal. Although it must be com-
bined with existing techniques for
nuclear hemisection, the advantages
of AC/NE warrant consideration for
inclusion in the modern cataract
surgeon's arsenal. I propose reclas-
sifying vertical chop into posterior
(traditional) chop and anterior chop
based on the directional component
of the chopper. EW
Editors' note: Dr. Elieff practices with
North Dallas Eye Associates, Plano,
Texas. He has no financial interests
related to his comments.
Contact information
Elieff: gordananda@aol.com
Device focus
Alternative continued from page 37
Figure 6 A and B. AC/NE is performed without femtosecond laser pre-chop.
Source (all): Steve Elieff, MD
