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Year : 2016  |  Volume : 29  |  Issue : 3  |  Page : 627-631

Divide and conquer versus chopping in phacoemulsification: study of the operation events and early results

1 Department of Ophthalmology, Faculty of Medicine, Menoufia University, Menoufia, Egypt
2 Department of Ophthalmology, Mansoura Ophthalmic Hospital, Mansoura, Egypt

Correspondence Address:
Yousef H. M. Ibrahim Mansour
Department of Ophthalmology, Mansoura Ophthalmic Hospital, Mansoura
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1110-2098.198744

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Objectives The aim of the study is to evaluate the efficacy and safety of the divide-and-conquer technique versus chopping technique in phacoemulsification. Background Kelman in 1967 introduced ultrasonic phacoemulsification for cataract removal, aiming to find a safer and more effective way of removing the lens. At present, phacoemulsification is the procedure of choice for cataract extraction for most ophthalmologists. Materials and methods This prospective study included 30 eyes of 30 patients attending the outpatient clinic of Menoufia Ophthalmic Department. Patients aged 40-60 years old with senile cataract nuclear grades from 2 to 4 underwent detailed history taking, full ophthalmic examination, A-B scan ultrasonography, corneal pachymetry and endothelial cell density measurements, and nuclear grading. All patients were operated by the same surgeon using Geuder megatron s3 machine. Results There was statistically significant endothelial cell loss (ECL) following all studied techniques 3 months postoperatively (12.4 and 10.5% in groups I and II, respectively). There was no significant difference between all studied groups. The nuclear grade and absolute phaco time had positive correlation with higher ECL, whereas age, sex, and axial length did not affect ECL. A significant increase in the central corneal thickness (CCT) was observed at the immediate postoperative week among the two studied groups (14 and 10.5%, respectively). There was no statistically significant difference between the two groups. The postoperative CCT pachymetry values were returned to near preoperative values at 3 months postoperatively. Conclusion Significant and equal ECLs occur after the two studied techniques. Absolute phaco time and nuclear grade have a positive correlation with higher ECL. Age, sex, and axial length do not affect ECL. CCT increases significantly and equally postoperatively following the two techniques.

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