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[Experiences with "reversed tip and snip" phacoemulsification]

M Kohlhaas1, A Walter

  • 1Universitäts-Augenklinik Hamburg-Eppendorf.

Der Ophthalmologe : Zeitschrift Der Deutschen Ophthalmologischen Gesellschaft
|September 17, 1998
PubMed
Summary
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The "reversed tip and snip" phacoemulsification technique causes less corneal endothelial cell loss than the "divide and conquer" method. This technique also shows a brief learning curve for surgeons.

Area of Science:

  • Ophthalmology
  • Corneal Surgery
  • Phacoemulsification Techniques

Background:

  • Endothelial cell count is a key indicator of corneal trauma post-phacoemulsification.
  • Phacoemulsification techniques vary in their impact on corneal endothelium.

Purpose of the Study:

  • To compare the corneal endothelial cell loss between the "reversed tip and snip" and "divide and conquer" phacoemulsification techniques.
  • To evaluate the learning curve associated with the "reversed tip and snip" technique.

Main Methods:

  • Prospective, randomized study comparing two phacoemulsification techniques in 30 patients each.
  • Corneal endothelial cell count measured preoperatively and at 4 weeks and 3 months postoperatively.
  • Phacotime and phacoenergy per second analyzed to assess learning curve for the "reversed tip and snip" technique.

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Main Results:

  • "Reversed tip and snip" resulted in ~10% endothelial cell loss; "divide and conquer" resulted in ~15% cell loss (P < 0.001).
  • The "divide and conquer" technique caused significantly greater endothelial cell loss.
  • Phacotime and phacoenergy per second significantly decreased from early to later cases (patients 1-30 vs. 31-60) of the "reversed tip and snip" technique (P < 0.05).

Conclusions:

  • The "reversed tip and snip" technique is associated with less endothelial cell loss compared to the "divide and conquer" technique.
  • A short learning curve exists for mastering the "reversed tip and snip" phacoemulsification technique.