Comparison of Phaco-Chop versus Stop-and-Chop Nucletomy Techniques in Patients with Soft to Moderate Nucleus Cataracts

Budiman Budiman, Andrew M. H. Knoch, Emmy Dwi Sugiarti, Ludwig Melino Tjokrovonco

Abstract


Various phacoemulsification techniques are commonly used, with phaco-chop and stop-and-chop techniques as the most popular ones. Phacoemulsification inevitably leads to endothelial cell destruction, which, in severe cases, might result in vision impairment. This study aimed to compare endothelial cell characteristics between two phacoemulsification procedures, phaco-chop, and stop-and-chop, in patients with soft to moderate nucleus cataracts. This study was conducted on 142 patients at the National Eye Center of Cicendo Hospital between April and August 2018. Of those, 66 patients underwent the phaco-chop technique, while 76 patients underwent the stop-and-chop technique. Intraoperative parameters such as effective phaco time (EPT), phaco time, average power, and duration were recorded. Endothelial density, hexagonality, coefficient of variation (CV), and central cornea thickness (CCT) were also recorded before surgery, as well as one week and four weeks after surgery. Mean power, EPT, phaco time, and duration in the phaco-chop group were significantly lower than in the stop-and-chop group. Mean (SD) endothelial density at one-week and four-week evaluation in the phaco-chop group were considerably lower than in the stop-and-chop group (p-value=0.024 and p-value=0.000, respectively). Mean (SD) CV at one-week evaluation in the phaco-chop group was significantly higher compared to a stop-and-chop group, 43.3 (8.0) versus 40.0 (6.7) % (p-value=0.009). Mean (SD) hexagonality at four-week evaluation in the phaco-chop group was significantly higher compared to a stop-and-chop group (43.1 (17.6) versus 48.7 (13.2) respectively, p-value=0.045). Phaco-chop technique have significantly lower EPT, average power, phaco time, and surgery duration than stop-and-chop techniques at one-week and four-week evaluation after phacoemulsification.


Keywords


Anterior chamber depth, cataract, endothelial cell, phacoemulsification

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References


  1. Park J, Yum H, Kim MS, Harrison AR, Kim EC. Comparison of phaco-chop, divide-and-conquer, and stop-and-chop phaco techniques in microincision coaxial cataract surgery. J Cataract Refract Surg. 2013;39(10):1463–9. doi:10.1016/j.jcrs.2013.04.033
  2. Astriani N, Sulistya TB, Sujuti H. Effectivity of nucleofractis technique to corneal endothelial cells. Eye Sight J. 2022;4(2):46–53.
  3. Hwang HB, Lyu B, Yim HB, Lee NY. Endothelial cell loss after phacoemulsification according to different anterior chamber depths. J Ophthalmol. 2015;2015:21071.
  4. Hwang HB, Lyu B, Yim HB, Lee NY. Endothelial cell loss after phacoemulsification according to different anterior chamber depths. J Ophthalmol. 2015;2015:210716.
  5. Park JH, Lee SM, Kwon J-W, Kim MK, Hyon JY, Wee WR, Lee JH, Han YK. Ultrasound energy in phacoemulsification: a comparative analysis of phaco-chop and stop-and-chop techniques according to the degree of nuclear density. Ophthalmic Surg Lasers Imaging. 2010;41:236–41. doi:10.3928/15428877-20100303-13
  6. Schulze S, Bertelmann T, Manojlovic I, Bodanowitz S, Irle S, Sekundo W. Changes in corneal endothelium cell characteristics after cataract surgery with and without use of viscoelastic substances during intraocular lens implantation. Clin Ophthalmol. 2015;9:2073–80.
  7. Ibiary HE, Fawzy H. Endothelial Cell Loss after Phacoemulsification according to different anterior chamber depths in hard cataract. Medical J Cairo University. 2022;90(3):573–82
  8. Sharma N, Kumar Y. Phaco chop versus stop and chop nucleotomy techniques: A comparative evaluation. Indian J Clin Exp Ophthalmol. 2018;4(1):3-6.
  9. El-Din Farahat HG, Badawy NM, Wagdy Faried FM, Ibrahim Mansour YH. Divide and conquer versus chopping in phacoemulsification: study of the operation events and early results. Menoufia Med J. 2016;29:627–31.
  10. Mehra P, Kumar Verma R. Evaluation of corneal endothelial cell loss in different grades of nucleus during phacoemulsification. Int J Med Res Rev. 2015;3(10):1128–32.
  11. Dzhaber D, Mustafa O, Alsaleh F, Mihailovic A, Daoud YJ. Comparison of changes in corneal endothelial cell density and central corneal thickness between conventional and femtosecond laser-assisted cataract surgery: a randomised, controlled clinical trial. Br J Ophthalmol. 2020;104(2):225–9. doi:10.1136/bjophthalmol-2018-313723.
  12. Reuschel A, Bogatsch H, N.Oertel, Wiedemann R. Influence of anterior chamber depth, anterior chamber volume, axial length, and lens density on postoperative endothelial cell loss. Graefe’s Arch for Clin Experimental Ophthalmol. 2015;253(5):745–52.
  13. Chen HC, Huang CW, Yeh LK, Hsiao FC, Hsueh YJ, Meir YJ, et al. Accelerated corneal endothelial cell loss after phacoemulsification in patients with mildly low endothelial cell density. J Clin Med. 2021;10(11):2270. doi:10.3390/jcm10112270




DOI: https://doi.org/10.15395/mkb.v56.3184

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