This video demonstrates a modified trench and chop technique, the "chop and tumble nucleotomy," as a safe and effective method for nuclear emulsification in posterior polar cataract (PPC). Conventionally, hydrodissection and nuclear rotation are avoided in PPC, which makes nuclear emulsification in these cases challenging. In this modified technique, a central chop is first performed to divide the nucleus, followed by the creation of 2 relatively large pie-shaped segments on either side, which are tumbled toward the center and emulsified. The remaining nuclear segments are then tumbled toward the center using the second instrument, chopped into smaller fragments, and emulsified, without any rotational maneuvers. In PPC, where rotation of nucleus is often not possible, the technique allows the surgeon to successfully emulsify the nucleus within the intact epinuclear cushion, which safeguards the weak posterior capsule. This technique has been performed successfully in 58 consecutive cases of PPC with no incidence of intraoperative posterior capsular dehiscence.

Financial Disclosure: Drs. Manpreet Kaur, Sridevi Nair, and Jeewan Titiyal disclose no financial relationships.