Crater-and-chop technique for phacoemulsification of hard cataracts.

We describe a technique of in-the-bag phacoemulsification of large, hard, leathery brown nuclear cataracts. A large crater approximately 6.0 mm diameter is created by down-slope sculpting up to 90% of nuclear thickness, leaving the outer nuclear rim intact. The edge of the crater is held with the phaco probe using high vacuum, and small wedge-shaped pieces are created with a chopper. These small pieces are emulsified in the space created by the crater. This technique permits in-the-bag phacoemulsification of large brown cataracts without complications.