I see a lot of slick videos of surgeons who do vertical chop, horizontal chop, chop and flip, stack and flack (just kidding on that last one). So sometimes I feel like a loser doing my standard divide and conquer. But it works really well for me, and I like the idea of doing the bulk of the phaco in the bag, away from the endothelium- it keeps my corneas nice and clear, and my complication rate is, thank God, pretty low. If the nucleus is pretty dense, then i will chop the quadrants. I get the feeling that compared to divide-and-conquer, chopping is faster, and that’s the main draw among high volume surgeons. Perhaps you also save a little bit in phaco energy, but since a lot of the phaco energy is in the bag using divide-and-conquer, it explains why in a head-to-head study there was no difference in corneal clarity or endothelial cell loss between the two.

So, I think it’s good for us to be familiar with all techniques, but  for all us “losers” who are doing divide-and-conquer- cheer up!