Phaco Prechop versus Divide and Conquer Phacoemulsification: A Prospective Comparative Interventional Study

To compare two phaco techniques, namely Phaco Prechop and Divide and conquer, basically during their early learning curves.

The study included 50 patients divided into 2 groups, each including 25 patients; group (A) where phaco Prechop was performed, and group (B) in which divide and conquer was performed. The mean effective ultrasound time, mean endothelial cell count, mean endothelial cell loss, corneal thickness, intraoperative complications, and the best corrected visual acuity were reported in the two groups both preoperative and postoperative.

The mean effective ultrasound time in group A was 19.36 ± 8.51 seconds, and in group B, it was 24.44 ± 7.86 seconds with a statistically significant difference between the two groups (P = 0.033). The mean endothelial cell count 3 months postoperative in group A was 2139.88 cells/mm(2). In group B, the mean endothelial cell count 3 months postoperative was 2087.08 cells/mm(2). The difference between the two groups was statistically insignificant (P = 0.558), however The difference in endothelial cell loss 3 months postoperatively between the two groups was statistically significant. (P = 0.001). Four cases in groups A (16%) had posterior capsular rents compared to three cases (12 %) in group B. Postoperative best corrected visual acuity in group B was 6/12 or better in 88% of cases as compared to 92% in group A with no statistical difference.

Early cataract surgical cases performed with the Phaco Prechop and divide and conquer techniques showed comparable results and complications. However the former technique utilized less phaco time and energy without significant effect on the final surgical outcome.