Early Postoperative Comparison And Correlation With Surgical Parameters Among Three Phacoemulsification Techniques

Comparison of outcomes and surgical parameters in medium-density cataracts among three different phacofragmentation techniques including "double chop" technique.

This study was conducted at the Fundación Oftalmológica de Santander (FOSCAL), a tertiary referral center in Colombia. The data were obtained from a prospective cohort of patients undergoing phacoemulsification surgery in the ophthalmology department.

Secondary analysis of an anonymized database from a prospective cohort.

Clinical characteristics and operative variables were recorded and compared.

A total of 156 eyes from 145 patients underwent surgery using three techniques: Divide and Conquer (52 eyes), Stop & Chop (53 eyes), and Double Chop (51 eyes). Surgeon 1 mainly used Divide and Conquer (94.23%) and Double Chop (72.55%), while Surgeon 2 preferred Stop & Chop (67.92%). Significant differences were found in surgical parameters, especially fluid volume, CDE, surgical, and ultrasound time. Endothelial loss was higher in Stop & Chop but lost significance in post-hoc analysis. No significant correlations were found between endothelial loss and intraoperative variables. Differences in surgical parameters were significant for CDE in Divide and Conquer and Stop & Chop.

This study compared the Divide and Conquer, Stop & Chop, and Double Chop techniques, the latter introduced in 2016. While increased CDE, ultrasound time, and fluid volume are known risk factors for endothelial loss, statistical significance was not reached, likely due to surgeon variability and uneven technique distribution. Mechanical techniques like Double Chop, which use less ultrasound, may lower endothelial damage risk. However, further studies with larger sample sizes and standardized case distribution are needed for a more precise comparison.