Application of a prechop technique using a reverse chopper in small pupil cataract surgery

Area of Science:

• Ophthalmology
• Surgical Techniques
• Cataract Surgery

Background:

• Cataract surgery in patients with small pupils presents unique challenges.
• The prechop technique using a reverse chopper is a potential solution for nucleus splitting in these cases.

Purpose of the Study:

• To evaluate the efficacy and safety of the prechop technique with a reverse chopper in small-pupil cataract surgery.
• To compare outcomes with standard cataract surgery in patients with normal pupil sizes.

Main Methods:

• A prospective case-control study involving 34 patients (34 eyes) divided into small pupil (18 eyes) and normal pupil (16 eyes) groups.
• The prechop technique was applied to both groups, with follow-up for three months.
• Key metrics analyzed included best-corrected visual acuity (BVCA), surgical complications, corneal endothelial cell loss, pupil function, operative time, and cumulative dissipated energy (CDE).

Main Results:

• No significant differences were observed between the groups in operative time, intraoperative ultrasound energy, BVCA, or surgical complications (P>0.05).
• The small pupil group showed significant improvement in BVCA post-surgery and enhanced pupillary light reflex and diameter.
• Corneal endothelial cell loss was slightly higher in the small pupil group but not statistically significant.

Conclusions:

• The prechop technique with a reverse chopper is comparable to standard techniques in small-pupil cataract surgery regarding operative time, energy consumption, BVCA, pupil morphology, and cell loss.
• This technique is deemed safe, efficient, simple, and easy to operate for small-pupil cataract surgeries.