Use Of An Illuminated Chopper In Phacoemulsification

To determine the advantages and efficiency of an illuminated chopper in phacoemulsification cataract surgery.

The Nam illumination probe with chopper, Oculight, Inc. is a new device combining illumination with a chopper for improved visualization and manipulation during cataract surgery. This instrument is USA FDA approved and has been proposed to be valuable in cases in which there is poor pupillary dilation. This is a retrospective review of sequential patients who underwent phacoemulsification cataract extraction with and without this instrument by a single surgeon.

Basic demographic data, preoperative risk factors, surgical parameters (time of surgery, energy used), presence of intraoperative complications and postoperative visual acuity were collected. After each surgery, the surgeon was asked to rate on a scale of 1 to 3: difficulty of case, visualization ability, chopper effectiveness. Continuous variables are expressed as means and standard deviations and compared with a student's T test. Categorical variables are summarized as frequencies and percentages.

9 patients had surgery without the assistance of the oculight chopper and 9 patients underwent surgery with the assistance of the oculight chopper. There was no significant difference in preop visual acuity. The duration of surgery was statistically similar between the two groups. There was no significant difference in power used between the two groups. The median VA and IOP at POD1 was not significantly different between the two groups. In the 9 patients for whom the illuminated chopper was used, 6/9 of the visualization was better than without the illuminated chopper. However, 7/9 of the cases that used the illuminated chopper the surgeon did not feel that the chopping capacity was improved.

There was no significant difference in intraoperative parameters or outcomes by using this surgical instrument. However, subjectively the surgeon reported improved posterior visibility with use of the illuminated chopper.  Further studies should be undertaken to determine whether the Oculight illuminated chopper may be helpful under small pupil conditions.  This instrument may also be useful for gauging lens thickness for the novice cataract surgeon.