A High Vacuum Phacoemulsification Technique (Coaxial Or Biaxial) Avoiding The Use Of Choppers And Prechoppers

To determine that the use of high vacuum in an stable anterior chamber, can allow a technique free of choppers and prechoppers during phaco, with only an irrigating or no-irrigating cannula, as a second device.

Centro Oftalmológico Dr. Arturo Pérez Arteaga, Tlalnepantla, México

A prospective study of two groups of 100 eyes with senile cataract were operated with phacoemilsification, comparing the vacuum level and the use of choppers. In the control group a traditional prechop technique was performed inside the capsular bag followed by phacoemulsification of fragmented nuclear pieces with low or medium vacuum leves; in the experimental group the whole nucleus was extracted from the capsular bag with high vacuum (assuring the anterior chamber stability with forced infusion), and then fragmented at the iris plane with the help of a cannula as a second instrument (irrigating in the case of biaxial technique, and non irrigating in the case of coaxial technique) 

When the variables were  measured and compared between the two groups,  we found significative differences in the vaccum level it self, total phaco time, incidence of PC rupture, and number of times changing instrumentation (and so total surgical time). No signifficative differences were found in endothelial cell count, postoperative recovery time and final visual acuity.  

A surgical phacoemulsification technique using high vacuum levels, can help to avoid the use of choppers, and the need of surgical maneuvers inside the capsular bag, decreasing the incidence of capsular or zonnular damage, the surgical time and the phaco time.