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Supported by an unrestricted independent medical educational grant from Alcon

Commercially supported by, Glaukos, MST, and Crestpoint Management

In kind support by Sony Healthcare Solutions

CME Video of the Month

Episode 2

January, 2016

The Impale and Chop Technique

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Surgery Description

Using a 2.4mm incision, I remove a fairly dense, 3+ brunescent nuclear cataract from a patient whose other eye has only peripheral vision. I demonstrate using trypan blue to aid visualization of the capsulorhexis, and show how an OVD can be used to actually reposition an anterior subcapsular opacity prior to creating the capsulorhexis. A detailed presentation of the impale and chop technique follows with additional pearls including how to keep the phaco tip cool, and the advantage of using a slightly oversized surgical glove.


Financial Disclosure: Richard J. Mackool, MD & RJ Mackool, MD: Consultant: Alcon; Patent Holder: Crestpoint Management

Learning Objective

Discuss strategies that can improve visualization in order to create a capsulorhexis. Describe the steps in the impale and chop technique. Outline techniques aimed at reducing ultrasound.

Satisfactory completion: Learners must pass a post-test and complete an evaluation form to receive a certificate of completion. Your chosen sessions must be attended in their entirety. Partial credit of individual sessions is not available. If you are seeking continuing education credit for a specialty not listed below, it is your responsibility to contact your licensing/certification board to determine course eligibility for your licensing/certification requirement.

Accreditation Statement – In support of improving patient care, this activity has been planned and implemented by Amedco LLC and Review Education Group. Amedco LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Physicians (ACCME) Credit Designation – Amedco LLC designates this enduring material activity for a maximum of .25 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Target Audience: Ophthalmologists with an interest in cataract surgery.

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All rights reserved. Video used with permission.

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