Two-hole assisted phaco-chop technique: a more efficient method for safe nucleofractis vertical chopping

Area of Science:

• Ophthalmology
• Surgical Techniques
• Medical Education

Background:

• Cataract surgery requires specialized skills, with phaco-chop being a common technique.
• Training new surgeons in complex procedures like phaco-chop presents challenges.
• Improving surgical efficiency and safety during training is paramount.

Purpose of the Study:

• To evaluate the efficacy of a novel two-hole technique in enhancing the learning curve for the phaco-chop technique among surgeons-in-training.
• To determine if creating two holes in the lens nucleus can facilitate easier fracturing and removal.
• To assess the impact of this technique on surgical efficiency and safety.

Main Methods:

• Three first-year surgeons utilized the two-hole technique before performing standard phaco-chop.
• Data from 64 cases were analyzed, including divide-and-conquer, two-hole method, and standard phaco-chop.
• Key outcome measures were cumulative dissipated energy (CDE) and ultrasound time (UST).

Main Results:

• Surgeons-in-training demonstrated improved safety with standard phaco-chop after practicing the two-hole method.
• The two-hole technique facilitated deeper and more effortless nucleus impalement.
• While CDE showed no significant difference, ultrasound time (UST) was significantly reduced (P < 0.05).

Conclusions:

• The two-hole technique aids surgeons-in-training in acquiring phaco-chop skills more efficiently.
• Further research with larger sample sizes is recommended to validate these findings.
• A four-hole variation shows potential utility for experienced surgeons managing hardened nuclei.