The phaco hemi-flip: a method of lens removal in nuclei of soft to moderate density.

Although endocapsular nuclear fragmentation chopping techniques have allowed surgeons to decrease the amount of dissipated phaco energy in the anterior chamber and improve lens removal efficiency when compared with previous techniques, chopping maneuvers carry a small risk of capsular and zonular injury. Furthermore, in softer lenses, chopping techniques may be limited in providing sufficient nuclear cracking. Additionally, with torsional phaco technologies, adequate lens purchase may be suboptimal and lead to inefficient chopping. Supracapsular phaco techniques improve capsular safety, but may be challenging in small pupil/capsulorrhexis cases and place the corneal endothelium and anterior chamber tissues at greater risk to trauma from ultrasound energy. The phaco hemi-flip technique combines the advantages of these two approaches with a single endocapsular quick chop, followed by phacoaspiration removal of each heminucleus in the iris plane without further chopping or segmentation.