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Comparison of phaco-chop, divide-and-conquer, and stop-and-chop phaco techniques in microincision coaxial cataract
Juwan Park1, Hae Ri Yum, Man Soo Kim
1From the Department of Ophthalmology & Visual Science (Park, Yum, M.S. Kim, E.C. Kim), College of Medicine, Catholic University of Korea, Seoul, South Korea; the Department of Ophthalmology (Harrison), College of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
Purpose:
To compare the outcomes of coaxial microincision cataract surgery (MICS) performed with 3 phacoemulsification techniques (phaco-chop, divide-and-conquer, and stop-and-chop) according to cataract density.
Setting:
Bucheon St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea.
Design:
Prospective randomized clinical trial.
Methods:
Eyes with nuclear density from grade 2 to 4 were randomly subdivided into 3 groups (phaco-chop, divide-and-conquer, and stop-and-chop). Intraoperative measurements included ultrasound time (UST), mean cumulative dissipated energy (CDE), and balanced salt solution use. Clinical measurements included preoperative and 1 day, 1 month, and 2 month postoperative corrected distance visual acuity, central corneal thickness, and endothelial cell count.
Results:
Intraoperative measurements showed significantly less UST, CDE, and balanced salt solution use with the phaco-chop technique than with the divide-and-conquer and stop-and-chop techniques in the grade 4 cataract density group (P<.05). The percentage of endothelial cell loss was significantly lower in the phaco-chop group than in the divide-and-conquer and stop-and-chop groups in the grade 4 cataract density group 2 months after cataract surgery (P<.05).
Conclusions:
All 3 techniques may be effective for coaxial MICS in mild and moderate cataracts. However, in eyes with hard cataract having coaxial MICS, the phaco-chop technique can be more effective for lens removal, with less corneal endothelial damage, than the divide-and-conquer and stop-and-chop techniques.
Financial Disclosure:
No author has a financial or proprietary interest in any material or method mentioned.
