Comparison of phaco-chop, divide-and-conquer, and stop-and-chop phaco techniques in microincision coaxial cataract surgery.

Journal of Cataract and Refractive Surgery

PubMedID: 23910714

Park J, Yum HR, 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.
PURPOSE
To compare the outcomes of coaxial microincision cataract surgery (MICS) performed with 3 phacoemulsification techniques (phaco-chop, divide-and-conquer, and stop-and-chop) according to cataract density.

SETTING
Bucheon St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea.

DESIGN
Prospective randomized clinical trial.

METHODS
Eyes with nuclear density from grade 2 to 4 were randomly subdivided into 3 groups (phaco-chop, divide-and-conquer, and stop-and-chop). Intraoperative measurements included ultrasound time (UST), mean cumulative dissipated energy (CDE), and balanced salt solution use. Clinical measurements included preoperative and 1 day, 1 month, and 2 month postoperative corrected distance visual acuity, central corneal thickness, and endothelial cell count.

RESULTS
Intraoperative measurements showed significantly less UST, CDE, and balanced salt solution use with the phaco-chop technique than with the divide-and-conquer and stop-and-chop techniques in the grade 4 cataract density group (P<.05). The percentage of endothelial cell loss was significantly lower in the phaco-chop group than in the divide-and-conquer and stop-and-chop groups in the grade 4 cataract density group 2 months after cataract surgery (P<.05).

CONCLUSIONS
All 3 techniques may be effective for coaxial MICS in mild and moderate cataracts. However, in eyes with hard cataract having coaxial MICS, the phaco-chop technique can be more effective for lens removal, with less corneal endothelial damage, than the divide-and-conquer and stop-and-chop techniques.

FINANCIAL DISCLOSURE
No author has a financial or proprietary interest in any material or method mentioned.