{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T14:53:29Z","timestamp":1791212009761,"version":"4.1.0"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"Suppl 3","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,10]]},"abstract":"\n Soft cataracts pose significant challenges during phacoemulsification due to the pliable nature of the nucleus, which often leads to difficulty in cracking, cheese-wiring of instruments, and frequent occlusion breaks. Several fragmentation and non-fragmentation techniques have been described to manage such cases safely. We describe an inverse chop\/prop technique that utilizes a blunt Sinskey hook to mobilize and crack the nucleus, facilitating safe and controlled phacoemulsification. This approach is also applicable for\n in situ<\/jats:italic>\n phacoemulsification in posterior polar cataracts (PPCs), eliminating the need for nucleus rotation. We used this technique in patients with lens opacities classification system (LOCS) III grade 1\u20132 soft cataracts and PPCs. The technique involves introducing the Sinskey hook beneath an uncracked, partially cracked, or cracked nucleus to further crack or prop it, enabling subsequent emulsification. In PPCs, the hook is inserted via either side port to mobilize and crack the nucleus without rotation, permitting direct\n in situ<\/jats:italic>\n emulsification. Cortex aspiration and intraocular lens (IOL) implantation are completed as per standard protocol. The technique was successfully performed in 188 patients without any procedure-related complications, including four cases with PPCs. In 50 cases, it proved particularly advantageous when conventional techniques encountered difficulty during emulsification. The inverse chop technique represents a valuable addition to the armamentarium for phacoemulsification of soft cataracts and PPCs, enhancing safety, control, and intraoperative efficiency.\n <\/jats:p>","DOI":"10.4103\/ijo.ijo_2206_25","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T16:00:42Z","timestamp":1781712042000},"page":"S473-S476","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Inverse chop\/Prop technique for phacoemulsification of soft cataracts and posterior polar cataracts"],"prefix":"10.4103","volume":"74","author":[{"given":"Vidhya","family":"Nagasubramanian","sequence":"first","affiliation":[{"name":"Department of Orbit and Oculoplasty, The Eye Foundation, Coimbatore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muralidhar","family":"Rajamani","sequence":"additional","affiliation":[{"name":"Department of Glaucoma, Strabismus, Neuroophthalmology and Pediatric Ophthalmology, The Eye Foundation, Coimbatore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramamurthy","family":"Dandapani","sequence":"additional","affiliation":[{"name":"Department of Cataract and Refractive Surgery, The Eye Foundation, Coimbatore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"R1-20261005","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1016\/j.jcrs.2011.04.018","article-title":"Phaco windmill: Nondividing, nonchopping phacoemulsification technique","volume":"37","author":"Keum","year":"2011","journal-title":"J Cataract Refract Surg"},{"key":"R2-20261005","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.jcrs.2010.10.032","article-title":"Visco-fracture technique for soft lens cataract removal","volume":"37","author":"Malavazzi","year":"2011","journal-title":"J Cataract Refract Surg"},{"key":"R3-20261005","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1016\/j.jcrs.2013.02.021","article-title":"Y sign: Clinical indicator to stop trenching and start cracking","volume":"39","author":"Kurian","year":"2013","journal-title":"J Cataract Refract Surg"},{"key":"R4-20261005","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.jcrs.2005.11.023","article-title":"Hydro-chop technique for soft lenses","volume":"32","author":"Braga-Mele","year":"2006","journal-title":"J Cataract Refract Surg"},{"key":"R5-20261005","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1016\/S0886-3350(13)80835-8","article-title":"The chip and flip phacoemulsification technique","volume":"17","author":"Fine","year":"1991","journal-title":"J Cataract Refract Surg"},{"key":"R6-20261005","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.1016\/j.jcrs.2007.05.027","article-title":"Management of the hard posterior polar cataract","volume":"33","author":"Chee","year":"2007","journal-title":"J Cataract Refract Surg"},{"key":"R7-20261005","doi-asserted-by":"crossref","first-page":"1350","DOI":"10.4103\/ijo.IJO_707_17","article-title":"Managing the posterior polar cataract: An update","volume":"65","author":"Vasavada","year":"2017","journal-title":"Indian J Ophthalmol"},{"key":"R8-20261005","doi-asserted-by":"crossref","first-page":"1008","DOI":"10.1038\/sj.eye.6702795","article-title":"\u2018Layer by layer\u2019 phacoemulsification in posterior polar cataract with pre-existing posterior capsular rent","volume":"22","author":"Vajpayee","year":"2008","journal-title":"Eye (Lond)"},{"key":"R9-20261005","doi-asserted-by":"crossref","first-page":"154","DOI":"10.3129\/i09-231","article-title":"Inverse horse-shoe technique for the phacoemulsification of posterior polar cataract","volume":"45","author":"Salahuddin","year":"2010","journal-title":"Can J Ophthalmol"},{"key":"R10-20261005","doi-asserted-by":"crossref","first-page":"1426","DOI":"10.1136\/bjo.87.11.1426-a","article-title":"Phacoemulsification of posterior polar cataracts \u2013 a surgical challenge","volume":"87","author":"Lee","year":"2003","journal-title":"Br J Ophthalmol"},{"key":"R11-20261005","first-page":"0","article-title":"Hydro-free mechanical delamination for phacoemulsification in cases of posterior polar cataracts","volume":"0","author":"Kodavoor","year":"2026","journal-title":"Niger J Ophthalmol"},{"key":"R12-20261005","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.1007\/s10792-018-0928-9","article-title":"Hook and flip technique: For phacoemulsification in non-rotating nuclei and posterior polar cataracts","volume":"39","author":"Gupta","year":"2019","journal-title":"Int Ophthalmol"}],"container-title":["Indian Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/IJO.IJO_2206_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T14:01:35Z","timestamp":1791208895000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/IJO.IJO_2206_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,17]]},"references-count":12,"journal-issue":{"issue":"Suppl 3","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/ijo.ijo_2206_25","relation":{},"ISSN":["0301-4738","1998-3689"],"issn-type":[{"value":"0301-4738","type":"print"},{"value":"1998-3689","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,17]]},"assertion":[{"value":"2025-08-31","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-08","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}