Zero energy phaco possible without a laser

Cataract surgeons have an addiction. We are ever in the pursuit of better outcomes for our patients with faster recovery times. With each technological leap in phaco machines and platforms, instruments and now laser-assisted cataract surgery, cataract surgeons are getting closer to zero energy phaco.Some have proposed femtosecond laser-assisted cataract surgery is a step toward zero energy phaco. Impressively, in 2013, Dick and Shultz shared their steps to obtaining zero energy phaco in 91% to 97% of their patients with the addition of not only the femtosecond laser, but also larger diameter irrigation and phaco tips and increasing the vacuum settings. We have been able to achieve similar results by manually fracturing the lens using a modification of the pop-and-chop technique described by Pandit and Oetting in 2003. This technique could be a valuable solution for many patients. Especially when considering the time and cost to both surgeons and patients, femtosecond adds to both categories.