Comparison of the phaco chop and drill-and-crack techniques for phacoemulsification of hard cataracts: A fellow eye study.
PURPOSE
To quantify the intraoperative parameters and postoperative outcomes after using the phaco chop technique in one eye and drill-and-crack technique in the other eye in patients with bilateral dense brunescent cataract.


METHODS
The Lens Opacities Classification System III grading system was used to select 132 eyes of 66 patients with bilateral nuclear opalescence (NO) grade NO4 or grade NO5. One eye in each patient with bilateral dense brunescent cataract was subjected to phacoemulsification using the phaco chop technique, while the other eye was subjected to phacoemulsification with the drill-and-crack technique for nucleus disassembly. The intraoperative parameters were quantified. Surgical outcome was assessed preoperatively and 1 day, 4 weeks and 12 weeks postoperatively, and the outcomes of the two techniques were compared.


RESULTS
There was no significant difference between the techniques in operative parameters [cumulative dissipated energy (p = 0.74), surgical time (p = 0.68) or surgical difficulty during nucleus disassembly (p = 0.80)]. There was no significant difference in the postoperative change in central corneal thickness between the techniques at day 1, 4 weeks and 12 weeks or in corneal endothelial cell density loss at 4 and 12 weeks (p > 0.05). There was no significant difference between the techniques in the mean corrected distance visual acuity (logarithm of the minimum angle resolution) at 4 weeks postoperatively (p = 0.25).


CONCLUSION
The phaco chop and drill-and-crack techniques are equally effective for disassembly of hard NO4 and NO5 cataracts.
['Abdelmotaal|Hazem|H|', 'Abdel-Radi|Mahmoud|M|https://orcid.org/0000-0002-9383-9520', 'Rateb|Mahmoud F|MF|', 'Eldaly|Zeiad H|ZH|https://orcid.org/0000-0002-2011-6620', 'Abdelazeem|Khaled|K|https://orcid.org/0000-0002-3437-6984']
D000368:Aged D000369:Aged, 80 and over D004728:Endothelium, Corneal D005260:Female D006801:Humans D019654:Lens Implantation, Intraocular D008297:Male D008875:Middle Aged D061646:Operative Time D018918:Phacoemulsification D011184:Postoperative Period D011446:Prospective Studies D016896:Treatment Outcome D014792:Visual Acuity
phaco chop drill-and-crack phacoemulsification nucleus disassembly