Drill and chop: modified vertical chop technique for hard cataract.

The authors describe a technique to improve the control and safety of vertical chopping during hard cataract surgery. Whereas the conventional vertical chop technique uses a sharp vertical chopper, the proposed technique uses a short blunt chopper. This requires complete engagement of the central nucleus by a phaco tip. The authors first drilled a hole into the endonucleus. By rotating the Kelman phaco tip clockwise, the nucleus was deeply impaled horizontally and firmly engaged with the phaco tip. This was followed by vertical chopping. This technique results in safer and more effective vertical chopping in patients with hard cataracts.