A Prechop Technique Using a Reverse Chopper

<i>Purpose</i>: To describe a manual prechop technique for splitting the nucleus of the lens using a recently developed reverse chopper. <i>Methods</i>: During the process, the reverse chopper and the Nagahara chopper are placed diagonally in the peripheral area of the nucleus of the lens after capsulorhexis. The reverse chopper and the Nagahara chopper then are pushed horizontally toward each other so they meet at the center of the lens to split the nucleus of lens into 2 parts. <i>Results</i>: In all cases, the reverse chopper was effective during the prechop procedure for hard nuclei, the nucleus of the lens remained <i>in situ</i> during the chopping process, and the reverse chopper did not retract the suspensory ligament in patients in whom the ligament was fragile. During the prechop procedure, no capsule breakage occurred, and the time and energy required for effective phacoemulsification were reduced significantly. <i>Conclusions</i>: The prechop technique using the reverse chopper can be applied for cases with grade III–V nuclei, overripe nuclei, and fragile suspensory ligaments. The procedure is simple, and the learning curve is not steep.