It is the beginning of the academic year, which in the USA runs from July 1 (start) until June 30 (end). Our ophthalmology residents have completed fewer cases at this point in the year and they are still trying to get up the learning curve for cataract surgery. A technique that I use for beginning surgeons who have completed fewer than 20 or 30 phaco surgeries is to pre-chop the nucleus into pieces before the resident places the phaco probe in the eye.
The Akahoshi pre-chopper is an instrument which can also be used to split the nucleus prior to putting the phaco probe in the eye. At our teaching hospital, we don't have this device so instead, I simply use a 27g blunt cannula to hold the nucleus while I use a standard chopper to split the nucleus into halves and then quarters.
This is not a technique that I personally use in my surgeries, but it is helpful when teaching a beginning surgeon.
