Dividing The Cataract Nucleus Into 4 Quadrants Without Using Ultrasound Or The Akahoshi Prechopper Technique
Published 2025 - 43rd Congress of the ESCRS
Reference: PO318 | Type: Free paper | DOI: 10.82333/8jyv-2m17
Authors: Zahra Javdani S. M.* 1 , Frank Goes 2 , Guido Van Hal 3 , Robert kuijpers 4 , Deborah Herrera 5
1Ophthalmology,Joseph Bracops Hospital,Brussels,Belgium, 2Ophthalmology,Oogarts-sion house,Braasschaat,Belgium, 3Epidemiology,university Antwerp,Antwerp,Belgium, 4Ophthalmology, Albert Schweitzer Hospital Dordrecht,Dordrecht,Belgium, 5Epiedemiology,university Antwerp,Antwerp,Belgium
Purpose
Cataract surgery is one of the most frequently performed eye surgeries worldwide, and among several techniques, phacoemulsification has become the standard of care due to its safety and efficiency. The techniques most used to fragment the cataract nucleus are divide-and-conquer and phaco-chop. An effective alternative to these 2 techniques is the use of an Akahoshi Prechopper. The Akahoshi Prechopper allows you to crack, divide and rotate the nucleus without sculpting.
Setting
Cataract surgery is performed in a tertiary centre at the Cliniques Universitaires Saint Luc, in Brussels. The surgeries are performed under local or general anaesthesia. The Akahoshi Prechopper technique is used systematically during cataract surgery in patients with moderate to hard density cataracts. Indeed, cracking is impossible with soft nucleus or brown cataracts.
Methods
The Akahoshi Prechopper is used directly after hydrodissection. The instrument must be directed horizontally during entry. It is then positioned vertically and directed towards the centre of the nucleus. In case of very hard nucleus, it is preferable to shear slightly and direct the tip of the Prechopper towards the inner part of the nucleus. Once firmly anchored in the nucleux, we pinch the Prechopper to allow it to open. This gives us 2 half-nucleus. We can now turn the core through 90 degrees to do the same thing and end up with 4 quadrants.
Results
We obtain the 4 quadrants of the cataract nucleus without even having introduced the phacoemulsification handpiece. This makes it possible to minimise the use of ultrasound during cataract surgery. In this way, we preserve the corneal endothelial cells even in the presence of cataracts with hard nucleus. The Akahoshi Prechopper technique also saves time during cataract surgery.
Conclusions
The Akahoshi Prechopper technique is effective on moderate to hard nucleus. It allows cataract surgery to be performed using less ultrasound. This means that endothelial cells and the cornea can be preserved. This technique is particularly effective in patients with a fragile endothelium, as in Fuchs Endothelial Dystrophy.