Comparison of divide and conquer and phaco-chop techniques during fluid-based phaco-emulsification.

Area of Science:

• Ophthalmology
• Surgical Techniques
• Cataract Surgery

Background:

• Cataract surgery commonly utilizes phacoemulsification for nucleus removal.
• Comparing different nucleus fragmentation techniques is crucial for optimizing surgical outcomes.
• Fluid-based phacoemulsification parameters are key indicators of surgical efficiency and safety.

Purpose of the Study:

• To compare the applied energy and surgery time between the phaco-chop and divide and conquer techniques in fluid-based phacoemulsification.
• To evaluate the efficacy of the Nagahara phaco-chop maneuver in cataract surgery.
• To assess if phaco-chop reduces fluid-based energy consumption compared to divide and conquer.

Main Methods:

• A prospective, randomized clinical study involving 50 patients with cataracts.
• Patients were assigned to either the divide and conquer technique (25 eyes) or the Nagahara phaco-chop maneuver (25 eyes).
• Surgical parameters, including fluid-based energy and time, were recorded and analyzed using the Wilcoxon signed-rank test.

Main Results:

• Phaco-chop significantly reduced fluid-based time, magnitude, effective fluid-based time, and pulse count compared to divide and conquer (p<0.001).
• Overall surgery time was comparable between the two techniques (p=0.97).
• No significant differences in visual acuity were observed between the groups post-surgery (p>0.05).

Conclusions:

• The Nagahara phaco-chop technique is effective for nuclear fragmentation in fluid-based cataract surgery.
• Phaco-chop demonstrates a reduction in applied fluid-based energy compared to the divide and conquer method.
• Surgery time is not shortened with phaco-chop due to difficulties in achieving adequate nucleus occlusion for the chop maneuver.