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This is a brick red/root beer color cataract. Whereas my usual phaco technique starts with an immediate horizontal chop, when it comes to these leathery dense cataracts I prefer...

This is a brick red/root beer color cataract. Whereas my usual phaco technique starts with an immediate horizontal chop, when it comes to these leathery dense cataracts I prefer a deep wide central groove using reverse sculpting (always sculpting into the greatest mass by rotating the lens frequently as the central groove is created) and then doing a deep central crack that splits the leathery posterior plate. At that point you have room to work so that the pieces don't act like a jigsaw puzzle and stay hinged at the base....you can seperate the pieces with chopping because you have created room to pull them apart. Although this is not the most "elegant" or flashy technique I believe it is the safest for this type of cataract. Steven G. Safran, MD.