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"Axe chopper, axe effect" in phacoemulsification
Session Title: Phaco Techniques
Session Date/Time: Saturday 05/10/2013 | 08:30-10:30
Paper Time: 09:40
Venue: Main Lecture Hall (Ground Floor)
First Author: : D.Nath INDIA
Co Author(s): : K. Sambhav K. Krishna S. Singh A. Singh
To evaluate the efficacy of new innovative way of phacoemulsification
Rural eye care settings in northern central India
Prospective non randomized comparative interventional case series of 200 eyes of 200 patients with senile cataract. Patients were divided into two groups of 100 each. Patients were having cataracts grade ranging from grade I to III. First group patients underwent phacoemulsification with direst chop technique and group two patients underwent phacoemulsification with “Axe chopper, axe Effect Technique.” All patients underwent complete pre operative evaluation. All patients with associated ocular illness which may affect the final outcome were excluded. In patients who underwent Axe effect phacoemulsification, entry wound were made and good CCC was completed along with hydro-procedures. Self designed axes are introduced into viscous filled anterior chamber. Axes are dipped into the substance of nucleus and nucleus is cracked into two pieces with tearing force. In the modified way, four holes were made with help of phaco hand piece in epicentral nuclear area. Two sinsky hooks were introduced into anterior chamber and nucleus was broken into 4 pieces. Phacoemulsification of the nuclear fragments was done. Irrigation aspiration of the cortical matter was completed and IOL of required power was implanted. Inter and intra group comparison of pre-operative and post-operative visual acuity, phaco time and surgical time was done.
Prospective non randomized interventional case series of 200 eyes of 200 patients over span of 1st July 2012 to 28th Feb 2012 were included in the study. All patients had minimal follow up of at least 6 weeks. Cataracts were senile in nature and nuclear sclerosis was grade I – III. Baseline demographic profiles were comparable in both the groups. The final outcome data had parametric distribution. Paired t-test was used for intra group comparison and unpaired t-test was used for inter group comparison. Mean best corrected Log MAR visual acuity at presentation in both the group was ≤0.5. Mean Log MAR best visual acuity at last post operative follow up was ≥0.1. The improvement was statically significant (p<0.001). The average phaco time in group I was 40 sec (range 7 – 81). The average phaco time in group II was 36 sec (range 5 – 72). Comparison of phaco time between both the group was statistically insignificant (p>0.5). Surgical time in both groups was comparable.
In our non-randomized study we concluded that both the techniques had comparable results. The direct chop/ stop & chop is well established mode of phacoemulsification and is documented to have least amount of phaco time needed for surgery. Our technique needed slightly less phaco time though statically insignificant difference was noted. Though our study has its own limitation of not being randomized and having small sample size but data had parametric distribution also with it, p value for phaco time was insignificant so it can be concluded that it is equally effective as direct chop phaco technique. Direct chop technique has its own learning curve. Our axe effect technique is very simple and has minimal learning curve. Axe effect is a technique which can be easily learned by beginner so it might hold an edge over other phaco techniques.