Phaco-Chop versus Divide-and-Conquer in Patients Who Underwent Cataract Surgery: A Systematic Review and
Jaime Guedes1,2, Sacha Fernandes Pereira3, Dillan Cunha Amaral4
1Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA, USA.
Clinical Ophthalmology (Auckland, N.Z.)
|June 3, 2024
Summary
Phaco-chop cataract surgery offers better outcomes than divide-and-conquer, with less endothelial cell loss and reduced ultrasound energy. This technique is safer for the corneal endothelium.
Area of Science:
- Ophthalmology
- Surgical Techniques
- Corneal Health
Background:
- Cataract surgery is a common procedure globally.
- Phacoemulsification is the standard technique for cataract removal.
- Comparing phaco-chop and divide-and-conquer techniques is crucial for optimizing patient outcomes.
Purpose of the Study:
- To compare the efficacy and safety of phaco-chop versus divide-and-conquer techniques in phacoemulsification.
- To evaluate key outcomes including endothelial cell count, ultrasound energy, and surgical time.
Main Methods:
- A systematic review and meta-analysis of randomized controlled trials and observational studies.
- Searched PubMed, Cochrane, Embase, and Web of Science databases.
- Analyzed data on endothelial cell count change, ultrasound time, cumulated dissipated energy, surgery time, and phacoemulsification time.
Main Results:
- Phaco-chop demonstrated a significant reduction in postoperative endothelial cell loss (MD -221.67 Cell/mm²).
- The phaco-chop technique resulted in shorter ultrasound time (MD -51.16 sec) and lower cumulated dissipated energy (MD -8.68 units).
- Phacoemulsification time was significantly reduced with phaco-chop (MD -55.09 sec), while overall surgery time showed no significant difference.
Conclusions:
- Phaco-chop technique is associated with fewer hazards to the corneal endothelium compared to divide-and-conquer.
- Reduced intraocular ultrasound energy delivery with phaco-chop contributes to better endothelial cell preservation.
- Phaco-chop emerges as a potentially superior technique for phacoemulsification cataract surgery.
