Endothelial cell damage after cataract surgery: divide-and-conquer versus phaco-chop technique

Area of Science:

• Ophthalmology
• Surgical Techniques
• Corneal Health

Background:

• Cataract surgery involves nuclear fracturing.
• Phaco-chop and divide-and-conquer are two common techniques.
• The potential for endothelial cell damage varies between techniques.

Purpose of the Study:

• To compare endothelial cell damage from phaco-chop versus divide-and-conquer techniques in cataract surgery.
• To evaluate the impact of nuclear fracturing methods on corneal endothelium.

Main Methods:

• Prospective study of 60 eyes undergoing cataract surgery.
• Random assignment to phaco-chop or divide-and-conquer groups.
• Measurement of phaco time, power, and corneal parameters (endothelial cell density, morphology, CCT) pre- and post-operatively.

Main Results:

• Phaco-chop used significantly less phaco power than divide-and-conquer.
• Both techniques resulted in similar, significant decreases in endothelial cell density.
• No significant changes in endothelial cell size variation, hexagonal cell percentage, or central corneal thickness were observed.
• Visual acuity improved equally in both groups.

Conclusions:

• The phaco-chop technique did not demonstrate less harm to the corneal endothelium compared to divide-and-conquer.
• Both techniques are associated with similar, low levels of endothelial cell loss post-surgery.
• Endothelial cell loss correlated with shorter axial length.