Comparison Between Two-Hole-Assisted-Phaco-Chop And Stop-And-Chop Techniques For Nuclear Disassembly In Residents’ Cataract Surgery

To evaluate the safety of the novel Two-Hole-Assisted-Phaco-Chop technique as a transition between Stop-and-Chop and Direct-Chop techniques and to compare its phacoemulsification parameters with the Stop-and-Chop technique.

Al-Shifa Trust Eye Hospital, Rawalpindi, Pakistan.

We included 103 patients (103 eyes), aged 18 years and above, with nuclear sclerosis NS+2, NS+3, +4, cortical, and Posterior sub-capsular cataracts (WHO Cataract Grading Group). We excluded patients with uveitis, glaucoma, traumatic cataracts, small pupils, zonular weakness, lens subluxation, small palpebral fissures, soft cataracts (NS+1), and posterior polar cataracts. The Stop-and-Chop technique was performed in 58 (56.3%) patients, while the Two-Hole-Assisted-Chop technique in the rest. Ultrasound Time (UST), total surgical time, and volume of BSS delivered were recorded.

The mean age of the participants was 65.12 ± 8.85 years. The comparison of the two techniques revealed no statistically significant difference in the UST (p=0.723), volume of BSS used (p=0.102), and total surgery time (p=0.517). However, a significant positive correlation between cataract grade and UST (Spearman’s r=0.888, p<0.001), BSS volume delivered (Spearman’s r=0.831, p <0.001), and surgery time (Spearman’s r=0.846, p<0.001) was observed. Moreover, UST comparison between cataract grades revealed a significant difference between the three groups (F= 185.09 p<0.001). A p-value of <0.05 was considered statistically significant.

The Two-Hole-Assisted-Phaco-Chop is a safe and efficient transitional technique between Stop-and-Chop and Direct-Chop techniques for nuclear disassembly in cataract surgery performed by resident surgeons. Additionally, the phacoemulsification parameters of the Two-Hole-Assisted-Chop technique are comparable with the Stop-and Chop technique.