The Escaf pre-chopper permits to fracture the nucleus of cataract with several grades (< grade 4), without the use of ultrasound, permitting to minimize the total amount of ultrasound energy used in the surgery, protecting the corneal endothelium. This is specially useful in cases of low corneal endothelial counts. This pre-chopper is safer than other pre-choppers in cases with small rhexis, because of its round edges. It also allows its use through a main clear corneal incision of 2.0mm, with great mobility thought such a small incision, preserving the anterior chamber stability. This instrument permits the mechanical fracture of the nucleus without the need to place metallic instruments at the lens equator, being safer to preserve the capsule, specially in cases with poorer visualization of the anterior segment due to corneal pathology. Additionally, I found this instrument very useful even in cases of total cataracts because it facilitates the separation of the two hemi-nucleus after performing the main groove with ultrasound, and even further to further divide the nucleus in smaller pieces after grooving, reducing the time spent to split the nuclear pieces. I think that this is an instrument that must be present in any cataract surgical tray.
Ivo Filipe Gama, MD
Trofa Saúde Health Group