A Comparative Study of Central Corneal Thickness and Endothelial Cell Density after Phacoemulsification by ‘Phaco-chop’ and ‘Divide and Conquer’ TechniquesCorrespondence Address :
Flat 204, Aditya Residency, Sawangi, Wardha, Maharashtra, India.
Introduction: Phacoemulsification was introduced by Kelman in 1967. It is one of the most important innovations in ophthalmology. This has now been accepted as gold standard surgical procedure for management of cataract. Divide and conquer technique, described by Gimbel, was the first nucleofractis cracking technique developed. Phoc-chop technique was presented by Kunihiro Nagahara in 1993 at the meeting of America Society Of cataract and Refractive Surgery.
Aim: To compare the Central Corneal Thickness (CCT) and endothelial cell density after phacoemulsification by ‘phaco-chop’ and ‘divide and conquer’ techniques.
Materials and Methods: The study included 100 patients divided into two groups, each including 50 patients; Group A, where Divide and Conquer was performed, and in Group B Phaco-chop was performed. The mean Absolute PhacoTime (APT), mean Endothelial Cell Count (ECC), mean Endothelial Cell Loss (ECL), corneal thickness and the visual acuity were reported in the two groups both preoperative and postoperative.
Results: The mean APT in group A was 27.12±10.15 seconds, and in group B, was 16.58±5.11 seconds (p=0.0001). The mean ECC at sixth week postoperative in group A was 2102. 14 cells/mm2 and in group B it was 2365.38 cells/mm2 (p=0.003). There was statistically significant ECL following sixth week postoperatively 16.22% in divide and conquer group and 8.51% in phaco-chop group (p-value=0.0001). A significant increase in the CCT was observed at the immediate postoperative week among the two studied groups; 3.16% in group A and 2.34% in group B, which was statistically significant. The postoperative CCT pachymetry values were returned to near preoperative values at one and a half months postoperative.
Conclusion: The phaco-chop technique utilises less phaco time and energy without significant effect on the final surgical outcome. Significant and equal ECL occurs after the two studied techniques. APT and nuclear grade have a positive correlation with higher ECL. CCT increases significantly and equally postoperatively following the two techniques.
Absolute phaco time, Cataract, Endothelial cell count
Date of Submission: May 14, 2020
Date of Peer Review: Jun 25, 2020
Date of Acceptance: Jul 28, 2020
Date of Publishing: Sep 01, 2020
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA
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