ESCRS - PO0461 - A Randomized Controlled Trial To Compare Terminal Chop, Stop-And-Chop And Direct Chop Techniques For Phacoemulsification

A Randomized Controlled Trial To Compare Terminal Chop, Stop-And-Chop And Direct Chop Techniques For Phacoemulsification

Published 2023 - 41st Congress of the ESCRS

Reference: PO0461 | Type: Free paper | DOI: 10.82333/8dhr-9p86

Authors: Aprajita Sinha* 1 , Arvind Kumar Morya 2 , Vinita Gupta 3

1Ophthalmology,Worcestershire Acute Hospitals NHS Trust,Worcester,United Kingdom, 2Ophthalmology,All India Institute of Medical Sciences,Bibinagar,India, 3Ophthalmology,All India Institute of Medical Sciences,Rishikesh,India

Purpose

To compare efficiency and safety of stop and chop, direct chop(vertical chop) and the novel terminal chop techniques of nuclear fragmentation for cataracts grade II-V.

Setting

The goal in developing new techniques of cataract surgery is to provide a safer, more efficient surgical experience with the lowest complication rate and endothelial cell loss. We have compared efficiency and safety of stop and chop, direct chop(vertical chop) and the novel terminal chop techniques of nuclear fragmentation for cataracts grade II-V. The study was conducted at a tertiary public hospital in India.

Methods

We conducted a prospective randomized controlled trial comparing three different techniques of phacoemulsification namely stop-and-chop, direct chop and terminal chop to assess any differences between them and to establish whether any one method was superior to the others. The pre- and post-operative parameters studied, included central corneal thickness (CCT), ultrasonic time (UST), endothelial cell density (CD), cell loss and effective phacoemulsification time (EPT), average cumulative dissipative energy (CDE) and  best corrected visual acuity, amongst others.

Results

Of a total of 307 eyes recruited to the study, 102 were recruited to the stop-and-chop group, 103 to the direct chop group and 102 to the terminal chop group. Statistical differences were found between the techniques with regards to post-operative CCT among NS II (p .0001) and NS IV cataracts (p=.005) with lowest values in terminal chop group among NS II, NS III and NS IV cataracts. Endothelial cell loss was minimum with terminal chop in NS II (p=.018) and NS IV cataracts (p=.245). CDE was minimum in terminal chop across different cataract densities.

Conclusions

Terminal chop showed improvement over other two techniques in terms of CDE and comparable to them with regards to other parameters. The recently introduced terminal chop technique was found to be efficient, safe, quick and reliable method for chopping different grades of nuclei.