Corneal endothelial changes after divide and conquer versus chip and flip phacoemulsification

Area of Science:

• Ophthalmology
• Surgical Techniques
• Corneal Science

Background:

• Phacoemulsification is a common cataract surgery method.
• Evaluating the impact of different phacoemulsification techniques on corneal health is crucial.
• Central corneal endothelial cells and thickness are key indicators of corneal health post-surgery.

Purpose of the Study:

• To compare the effects of divide and conquer (D/C) versus chip and flip (C/F) phacoemulsification on central corneal endothelial cells.
• To assess changes in corneal thickness following D/C and C/F phacoemulsification.
• To determine the safety and efficacy of these two phacoemulsification methods regarding corneal integrity.

Main Methods:

• Randomized comparison of D/C and C/F phacoemulsification in 41 eyes.
• All eyes received a foldable silicone intraocular lens.
• Corneal endothelial cell counts and thickness were measured preoperatively and at 1 week, 1 month, and 3 months postoperatively.

Main Results:

• No significant differences in patient demographics or surgical parameters between groups.
• The chip and flip (C/F) group showed greater endothelial cell loss at 1 month.
• Significant changes in hexagonal cells were observed: 1.1% increase in D/C group vs. 10.7% decrease in C/F group at 1 week.

Conclusions:

• The divide and conquer technique demonstrated superior outcomes in preserving corneal endothelial cells and minimizing hexagonal cell alterations compared to chip and flip.
• While initial differences were significant, they were not statistically significant at the 3-month follow-up.
• Both techniques are viable, but D/C may offer better short-term corneal protection.