Retrospective study on outcomes of terminal chop technique of nuclear fragmentation in phacoemulsification and combined surgery: An observational study

Morya, Arvind Kumar; Bhandari, Sahil; Naidu, Anushree

doi:10.4103/ijo.ijo_711_18

Cited by 3 publications

(3 citation statements)

References 6 publications

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“…The CDE in our study was found to be proportional to the grade of cataract in the terminal chop technique, which was also seen by Morya et al . [ 20 ] Park et al . [ 7 ] showed that CDE in NS IV cataracts was low in the phaco-chop technique with statistical significance but only for NS IV cataracts.…”

Section: Discussionmentioning

confidence: 99%

A randomized controlled trial to assess safety and efficacy between terminal chop, stop and chop, and direct chop

Sinha,

Morya,

Gupta

et al. 2023

Indian Journal of Ophthalmology

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Purpose: The goal in developing new techniques of cataract surgery is to provide a safer, more efficient surgical experience with the lowest complication rate and endothelial cell loss. We compared the efficiency and safety of stop-and-chop, direct chop, and the novel terminal chop techniques of nuclear fragmentation for cataracts grade II-V. Methods: We conducted a prospective randomized clinical trial comparing three different techniques of phacoemulsification, namely, stop-and-chop, direct chop, and terminal chop to assess any differences between them and to establish whether any one method was superior to the others. The pre- and postoperative parameters studied, included central corneal thickness (CCT), ultrasonic time (UST), endothelial cell density (CD), cell loss and effective phacoemulsification time (EPT), average cumulative dissipative energy (CDE), and best-corrected visual acuity, among others. Results: 307 eyes were recruited to the study, 102 were recruited to the stop-and-chop group, 103 to the direct chop group, and 102 to the terminal chop group. Statistical differences were found between the techniques with regard to postoperative CCT among NS II (P. 0001) and NS IV cataracts (P = .005) with the lowest values in the terminal chop group among NS II, NS III, and NS IV cataracts. Endothelial cell loss was minimum with a terminal chop in NS II (P = .018) and NS IV cataracts (P = .245). CDE was minimum in terminal chop across different cataract densities. Conclusion: Terminal chop showed improvement over the other two techniques in terms of CDE and was comparable to them with regard to other parameters.

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Section: Discussionmentioning

confidence: 99%

A randomized controlled trial to assess safety and efficacy between terminal chop, stop and chop, and direct chop

Sinha,

Morya,

Gupta

et al. 2023

Indian Journal of Ophthalmology

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“…Cataract developed in this manner is known as a senile cataract [1]. The only possible cataract treatment is a surgical one, and that procedure is entitled phacoemulsification [1,2]. Cataract surgery is one of the most commonly performed surgical procedures worldwide [3].…”

Section: The Effect Of Intraocular Lens Materials and Postoperative Thmentioning

confidence: 99%

“…Phacoemulsification breaks down the blood-aqueous barrier and releases inflammatory cytokines. This local inflammatory reaction activates "E" cells that proliferate, migrate, and lead to PCO [1,2]. Many methods are used to reduce inflammation and cells migration.…”

Section: The Effect Of Intraocular Lens Materials and Postoperative Thmentioning

confidence: 99%

The effect of intraocular lens material and postoperative therapy on the posterior capsule opacification development after the senile cataract surgery

et al. 2020

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Introduction/Objective The most frequent postoperative complication of a successfully performed phacoemulsification cataract surgery is the development of posterior capsule opacification (PCO). It is caused by the proliferation and migration of the remaining residual epithelial cells. The objective of this study was to investigate the influence of two different intraocular lenses and two different anti-inflammatory drugs on the development of PCO in one-year follow-up period. Methods Investigation included 120 patients (120 eyes), equally divided into four groups. The first two groups included patients who used non-steroid anti-inflammatory drug (NSAID) postoperatively, while the other groups had corticosteroid therapy. The first and third group got hydrophilic intraocular lenses (IOL), the second and fourth group had hydrophobic IOL. Software program EPCO 2000 was used for the analysis of PCO. Student's t-test, Wilcoxon test, and ANOVA were used for data analysis and p < 0.05 value was accepted as statistically significant. Results After the first three postoperative months, patients from NSAID groups had mean PCO score 0.25 ± 0.03, which was statistically significant higher (p = 0.042) comparing to corticosteroid groups. At the end of the investigation, the best result in PCO preventing was seen in the group of patients with hydrophobic IOL and corticosteroid therapy, with the mean PCO score of 0.47 ± 0.08. Conclusion This study has revealed that IOL made of acrylic hydrophobic material seemed to be the right choice when choosing intraocular lens to prevent PCO development. On the other hand, NSAID and corticosteroid therapy have showed similar results in preventing postoperative intraocular inflammation. This fact can be very useful in situations when corticosteroids must be used with great caution.

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Phacoemulsification Techniques and Their Effects on Corneal Endothelial Cells and Visual Acuity: A Review of "Direct-Chop" and "Stop-and-Chop" Approaches Under Topical Anesthesia

Upasani,

Daigavane

2024

Cureus

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Phacoemulsification is a widely adopted technique in cataract surgery that offers a minimally invasive approach to lens removal and intraocular lens implantation. Among the various methods of phacoemulsification, "direct-chop" and "stop-and-chop" techniques are particularly notable for their efficiency and safety profiles. This review aims to evaluate the effects of these two techniques on corneal endothelial cells and visual acuity, specifically under topical anesthesia. Cataract surgery outcomes hinge on the preservation of corneal endothelial cells and the achievement of optimal visual acuity. Endothelial cell loss can lead to corneal decompensation, while visual acuity is a primary measure of surgical success. The "direct-chop" technique involves the immediate chopping of the lens nucleus after groove creation, reducing phacoemulsification time and energy. Conversely, the "stop-and-chop" technique incorporates a central groove before chopping, offering increased control and safety. This review synthesizes current research and clinical studies to compare these techniques, focusing on their respective impacts on endothelial cell count and postoperative visual acuity. It examines the advantages and disadvantages of each approach, considers the role of surgeon experience, phacoemulsification energy, and anterior chamber stability, and assesses patient outcomes under topical anesthesia. The findings aim to provide insights that can guide surgeons in selecting the most appropriate technique for their patients, ultimately enhancing surgical outcomes by ensuring the preservation of corneal health and the achievement of superior visual acuity.

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Retrospective study on outcomes of terminal chop technique of nuclear fragmentation in phacoemulsification and combined surgery: An observational study

Cited by 3 publications

References 6 publications

A randomized controlled trial to assess safety and efficacy between terminal chop, stop and chop, and direct chop

A randomized controlled trial to assess safety and efficacy between terminal chop, stop and chop, and direct chop

The effect of intraocular lens material and postoperative therapy on the posterior capsule opacification development after the senile cataract surgery

Phacoemulsification Techniques and Their Effects on Corneal Endothelial Cells and Visual Acuity: A Review of "Direct-Chop" and "Stop-and-Chop" Approaches Under Topical Anesthesia

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