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Blind chopping: a new technique to handle small pupils during cataract surgery without expanding devices

Poster Details

First Author: J.Vryghem BELGIUM

Co Author(s):                        

Abstract Details


To describe a chopping technique that enables the surgeon to perform cataract surgery in eyes with small pupils without the use of pupil-expanding devices, thereby eliminating the challenges associated with their use.


Brussels Eye Doctors, private practice in Brussels, Clinique du Parc LĂ©opold, Brussels.


Phaco chop with a bimanual approach, using the Signature phaco system (Abbott Medical Optics Inc.), with a self-developed titanium irrigating chopper with an ultrathin wall, a larger lumen than other choppers and a Nagahara tip (the Vryghem chopper A.R.C. Laser GMBH). First the tip is rotated perpendicular to the surface of the nucleus and moved centrifugally under the margin of the capsulorhexis. When the equator is reached, the tip is then turned downward in the direction of the optic nerve, and the equator of the lens is captured by the inner side of the tip of the chopper.


After a learning curve, blind chopping using the Vryghem irrigating chopper gives the surgeon the advantage of no longer being bothered by small pupils. The ability to manage these cases without special instruments and other preparations will save a lot of time.


Blind chopping carries little risk of zonulolysis or capsular rupture, as long as the Nagahara tip of the Vryghem irrigating chopper is introduced underneath the rhexis. After a learning curve, blind chopping using the Vryghem irrigating chopper can relieve the surgeon of the challenges associated with small pupils and reduce surgical time.

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