Comparison of Phaco-chop and Divide and Conquer Methods in Grade 3-4 Cataract Patients
Article Sidebar
Main Article Content
Abstract
Purpose: To compare the outcomes of Grade3-4 cataract surgery performed with 2 phacoemulsification techniques (phaco-chop and divide-and-conquer).
Setting: Ministry of Health Tuzla State Hospital, Istanbul, Turkey.
Design: Prospective randomized clinical trial.
Methods: This is prospective and randomized(double blind) study cataract surgery using two different techniques of nuclear fragmentation performed at the Tuzla State Hospital.100 patients eye with nuclear density from grade 3 to 4 were randomly subdivided into 2 groups (phaco-chop and divide-and-conquer). Intraoperative measurements included Phaco time (PT), effective phaco time(EPT), mean phaco power(MPP). Clinical measurements included preoperative and postoperative 1.day , 7. day, 30. day, and 60.day corrected distance visual acuity(BCVA), time to achieve BCVA, corneal edema rate and time to disappear corneal edema.
Results: Intraoperative measurements showed significantly less PT, EPT, and corneal edema with the phaco-chop technique than divide-and-conquer techniques in the grade 3-4 cataract density group (P<0.05).
Conclusions: 2 techniques may be effective for cataract surgery in mild and moderate cataracts. However, in eyes with hard cataract the phaco-chop technique can be more effective for lens removal, with less Phaco time and corneal edema, then the divide-and-conquer technique.
Financial Disclosure: No author has a financial or proprietary interest in any material, method or device mentioned.
Article Details
References
Akahoshi T. Phaco prechop: Manual nucleofracture prior to phacoemulsi- fication. Op Tech Cataract Ref Surg. 1998;1:69–91.
Chylack LT, Wolfe JK, Singer DM, Leske MC, Bullimore MA, Bailey IL, et al. The Lens Opacities Classification System III. Arch Ophthalmol. 1993;111:831.
Can İ, Takmaz TC‚ Akıcı F, Ozgul M. Comparison of Nagahara phaco-chop and stop-and-chop phacoemulsification nucleotomy techniques. J Cataract Refract Surg. 2004;30:663–668.
Koch PS, Katzen LE. Stop and chop phacoemulsification. J Cataract Refract Surg. 1994;20:566–570.
Pirazzoli G, D’Eliseo D, Ziosi M, Acciarri R. Effects of phacoemulsification time on the corneal endothelium using phacofracture and phaco chop techniques. J Cataract Refract Surg. 1996;22:967–969.
DeBry P, Olson RJ, Crandall AS. Comparison of energy required for phaco-chop and divide and conquer phacoemulsification. J Cataract Refract Surg. 1998;24:689–692.
Wong T, Hingorani M, Lee V. Phacoemulsification time and power requirements in phaco chop and divide and conquer nucleofractis techniques. J Cataract Refract Surg. 2000;26:1374–1378.
Park, Juwan, et al. Comparison of phaco-chop, divide-and-conquer, and stop-and-chop phaco techniques in microincision coaxial cataract surgery. Journal of Cataract & Refractive Surgery. 2013; 39(10):1463-1469.
Menikoff JA, Speaker MG, Marmor M, Raskin EM. A case-control study of risk factors for postoperative endophthalmitis. Ophthalmology. 1991;98: 1761–1768.
Ram J, Wesendahl TA, Auffarth GU, Apple DJ. Evaluation of in situ fracture versus phaco chop techniques. J Cataract Refract Surg. 1998;24:1464–1468.
Hayashi K, Nakao F, Hayashi F. Corneal endothelial cell loss after phacoemulsification using nuclear cracking procedures. J Cataract Refract Surg. 1994; 20:44–47
Diaz-Valle D, Benı´tez del Castillo Sa´nchez JM, Castillo A, et al. Endothelial damage with cataract surgery techniques. J Cataract Refract Surg. 1998;24:951–955.
Fernández-Muñoz E, Zamora-Ortiz R, Gonzalez-Salinas R. Endothelial cell density changes in diabetic and nondiabetic eyes undergoing phacoemulsification employing phaco-chop technique. International Ophthalmology. 2018;1-7.
Coppola M, Marchese A, Rabiolo A, Cicinelli MV, Knutsson KA. Comparison of two popular nuclear disassembly techniques for cataract surgeons in training: divide and conquer versus stop and chop. International Ophthalmology. 2018;1-6.
Gross FJ, Garcia-Zalisnak DE, Bovee CE, Strawn JD. A comparison of pop and chop to divide and conquer in resident cataract surgery. Clinical Ophthalmology (Auckland, NZ). 2016;10:1847.