Incisions
Create access that supports chamber stability and instrument movement.
Phaco Roadmap
Horizontal direct chop, taught from first principles to fluent surgery.
The series grows with the resident: stable fundamentals first, efficient nucleus management next, then the judgement needed when the eye stops behaving like a routine case.
Progression
The endpoint is not speed. It is spare attention.
A junior needs a repeatable sequence. A senior needs enough control that attention can move from the hands to the eye: chamber behaviour, zonular response, pupil, capsule and the next decision.
Capsulorhexis
Build a centred, continuous opening that supports every later step.
Hydrodissection
Create mobility without using rotation as proof of success.
Direct chop setup
Place the phaco tip deep enough for control before the chopper commits.
Horizontal chop
Separate the nucleus with opposing vectors, not escalating ultrasound.
Segment removal
Bring pieces to a safe working zone while maintaining occlusion and followability.
Cortex and capsule
Use tangential aspiration and protect the posterior capsule.
IOL and finish
Confirm position, remove viscoelastic deliberately and leave a formed, quiet eye.