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Comparison between phaco-chop, Comparison between phaco-chop, divide-conquer and stop & chop divide-conquer and stop & chop
phaco-technique according to the phaco-technique according to the cataract densitycataract density
Hae ri Yum, M.D., Man Soo Kim, M.D.Hae ri Yum, M.D., Man Soo Kim, M.D.Eun Chul Kim, M.D.Eun Chul Kim, M.D.
Department of Ophthalmology and Visual Department of Ophthalmology and Visual Science, Science,
The Catholic University of KoreaThe Catholic University of Korea
No author has any financial or proprietary No author has any financial or proprietary interest interest
in any materials or methods mentionedin any materials or methods mentioned
IntroductionIntroduction
Phacoemulsification was the technique that was Phacoemulsification was the technique that was
performed in almost all cataract surgery. performed in almost all cataract surgery. When phacoemulsification was first introduced, When phacoemulsification was first introduced,
the nucleus was not divided and the phaco-the nucleus was not divided and the phaco-
emulsification probe was used to sculpt and emulsification probe was used to sculpt and
consume the nucleus. consume the nucleus. Compared with extracapsular cataract extraction,Compared with extracapsular cataract extraction,
phacoemulsification in associated with additionalphacoemulsification in associated with additional
potential risks of corneal endothelial cell damage.potential risks of corneal endothelial cell damage.
PurposePurpose
To compare the intraoperative and short-term To compare the intraoperative and short-term postoperative outcomes of cataract surgery postoperative outcomes of cataract surgery performed with 3 different types of the phaco-performed with 3 different types of the phaco-technique (phaco-chop, divide-conquer and technique (phaco-chop, divide-conquer and stop & chop) under microcoaxial or stop & chop) under microcoaxial or conventional cataract surgery according to the conventional cataract surgery according to the cataract density.cataract density.
Materials & MethodsMaterials & Methods
90 cataract eyes with nuclear density from Grade 90 cataract eyes with nuclear density from Grade 2 to 42 to 4
Cataract density Cataract density (NO2 ,NO3, NO4)(NO2 ,NO3, NO4)
Phaco-ChopPhaco-Chop Divide-ConquerDivide-Conquer Stop & ChopStop & Chop
Materials & MethodsMaterials & Methods
Intraoperative measurementsIntraoperative measurements Effective phacoemulsification time (EPT)Effective phacoemulsification time (EPT) Mean cumulative dissipated ultrasound energy (CDE)Mean cumulative dissipated ultrasound energy (CDE) Total balanced salt solution (BSS) useTotal balanced salt solution (BSS) use
Clinical measurements Preoperative, 1-day postoperative, 1,2-month Preoperative, 1-day postoperative, 1,2-month
postoperativepostoperative Best corrected visual acuity (BCVA)Best corrected visual acuity (BCVA) Central corneal thicknessCentral corneal thickness Endothelial cell countEndothelial cell count
ResultsResults
No significant difference between groups
ResultsResults
EPT: effective phacoemulsification timeCDE: mean cumulative dissipated ultrasound energyBSS: balanced salt solution
CDE(%) P value0.0030.033
*Tukey HSD and Duncan test
BSS use (ml) 0.017
P value
*Tukey HSD and Duncan test
0.048
EPT(sec) P value<0.001
0.009
*Tukey HSD and Duncan test
The phaco-chop technique can provide more effective lens
removal than divide-conquer and stop & chop phaco
technique with lower phacoemulsification time and energy
in the mature cataract.
ResultsResults
Endothelial cell count loss rate (%)
*Tukey HSD and Duncan test
Nuclear opacity
Although the mean endothelial cell loss was less in
phaco-chop groups than those in divide-conquer and
stop & chop groups , the difference between groups was
not significant statistically.
ResultsResults
CCT change (%)
*Tukey HSD and Duncan test
Nuclear opacity
CCT: central corneal thickness (μm)
Although the central corneal thickness increased after
phacoemulsification , there was less change in phaco-chop
than divide-conquer and stop & chop , the difference was not
significant.
ResultsResults
No significant difference between groups
ConclusionConclusion
The phaco-chop technique can provide more effective The phaco-chop technique can provide more effective
lens removal than divide-conquer with lower lens removal than divide-conquer with lower
phacoemulsification time and energy in the mature phacoemulsification time and energy in the mature
cataract.cataract.
However, the phaco-chop, divide-conquer and stop & However, the phaco-chop, divide-conquer and stop &
chop technique may be all effective for both of chop technique may be all effective for both of
microcoaxial and conventional incision cataract surgery.microcoaxial and conventional incision cataract surgery.
There is an advantage of phaco-chop over divide-conquer There is an advantage of phaco-chop over divide-conquer
and stop & chop in both CCT and ECC change but this and stop & chop in both CCT and ECC change but this
advantage is no significant difference statistically.advantage is no significant difference statistically.
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