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Comparative Studies | Ophthalmology | India | Volume 12 Issue 5, May 2023
A Study of Corneal Endothelial Damage Following Different Type of Phacoemulsification Techniques
Dr. Surabhi S | Dr. Shashidhar S [2] | Dr. Hithashree H R | Dr. Anoop L
Abstract: Background: Cataract is one of the leading cause of visual disability throughout the world, responsible for 51.3% of blindness (2.2 billion) [1]. Cataract is held to be responsible for 80% of bilateral blindness in India [2]. Aim: To evaluate and compare Corneal endothelial changes following Divide ? conquer versus. Stop-chop Phacoemulsification techniques. Settings and Design: A open label, randomised comparative study Methods and Material: A comparative study is done on 62senile cataract eyes that were prepared to have phacoemulsification surgery from February 2021 to August 2022 at our tertiary eye care Hospital. Total eyes were divided into two groups; each group had 31 eyes. One group subjected to ?stop and chop? phacoemulsification technique and other group subjected to ?divide and conquer? phacoemulsification technique. Statistical analysis used: The Statistical software namely SPSS 22.0, and R environment ver.3.2.2 were used. Results: Gender distribution of our study population was found to be 29 females (46.8%), 33 males (53.2%) In stop and chop, percentage of endothelial cell loss from preoperative cell count was 4.7%, 5.07%, 6.09%, 7.33%, 7.89% at POD 1, POD 1st week, POD 2nd week, POD 1month, POD 6th week respectively. In divide and conquer, percentage of ECL from preoperative cell count was 6.95%, 7.41%, 8.13%, 9.23%, 10.03% at POD 1, POD 1st week, POD 2nd week, POD 1month, POD 6th week respectively. In stop and chop, Percentage of Central corneal thickness increase from pre-operative CCT was 4.6%, 5.8%, 4.02%, 2.01%, 1.60% at POD 1, POD 1st week, POD 2nd week, POD 1month, POD 6th week respectively. In divide and conquer, Percentage of CCT increase from pre-operative CCT was 7.8% , 7.2%, 5.4%, 4.6%, 3.8% at POD 1, POD 1st week, POD 2nd week, POD 1month, POD 6th week respectively. Conclusions: Our study shows that there is significant percentage of endothelial cell loss in both groups post-operatively as compared to preoperative endothelial cell count. The study concluded that, there was no statistically significant difference between divide & conquer technique and stop & chop technique regarding endothelial cell loss. Increased CCT values were observed in divide & conquer technique as compared to stop & choptechnique. Both stop & chop technique and divide & conquer technique are equally efficacious for nuclear cracking in nuclear sclerosis grading 2, 3 and 4. But divide and conquer technique requires more ultrasound energy and effective phaco time compared to stop and chop technique.
Keywords: Divide and conquer, Stop and chop, endothelial cell count, central corneal thickness
Edition: Volume 12 Issue 5, May 2023,
Pages: 943 - 947