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  • Title: Comparison of phaco-chop, divide-and-conquer, and stop-and-chop phaco techniques in microincision coaxial cataract surgery.
    Author: Park J, Yum HR, Kim MS, Harrison AR, Kim EC.
    Journal: J Cataract Refract Surg; 2013 Oct; 39(10):1463-9. PubMed ID: 23910714.
    Abstract:
    PURPOSE: To compare the outcomes of coaxial microincision cataract surgery (MICS) performed with 3 phacoemulsification techniques (phaco-chop, divide-and-conquer, and stop-and-chop) according to cataract density. SETTING: Bucheon St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea. DESIGN: Prospective randomized clinical trial. METHODS: Eyes with nuclear density from grade 2 to 4 were randomly subdivided into 3 groups (phaco-chop, divide-and-conquer, and stop-and-chop). Intraoperative measurements included ultrasound time (UST), mean cumulative dissipated energy (CDE), and balanced salt solution use. Clinical measurements included preoperative and 1 day, 1 month, and 2 month postoperative corrected distance visual acuity, central corneal thickness, and endothelial cell count. RESULTS: Intraoperative measurements showed significantly less UST, CDE, and balanced salt solution use with the phaco-chop technique than with the divide-and-conquer and stop-and-chop techniques in the grade 4 cataract density group (P<.05). The percentage of endothelial cell loss was significantly lower in the phaco-chop group than in the divide-and-conquer and stop-and-chop groups in the grade 4 cataract density group 2 months after cataract surgery (P<.05). CONCLUSIONS: All 3 techniques may be effective for coaxial MICS in mild and moderate cataracts. However, in eyes with hard cataract having coaxial MICS, the phaco-chop technique can be more effective for lens removal, with less corneal endothelial damage, than the divide-and-conquer and stop-and-chop techniques. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.
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