Four-port bimanual phaco-chop fragmentation for dropped nucleus using standard phaco chopper and assistant handheld 23G endoilluminator.

Purpose: To describe a bimanual method for management of posteriorly dislocated large nucleus fragment using standard chopper.

Methods: A 23G assistant handheld endoilluminator was used as light source through inferonasal self-sealing port, while the large nuclear fragment was broken into smaller fragments using phacofragmatome and standard phaco chopper.

Results: A case of posteriorly dislocated large nuclear fragment was operated using this technique. The time taken for phacofragmentation was significantly reduced, as well as the ultrasound energy required for the same. There was no port site complication.

Conclusion: This technique allows greater maneuverability and reduces amount of ultrasound energy used by dividing nucleus into small fragments in vitreous cavity.