Fragmentation effective for white cataracts

THOROFARE, N.J. — Phacofragmentation is a viable option to phacoemulsification, especially in developing countries, said Istiantoro Soekardi, MD. While phacoemulsification is ideal for cataract surgery in developed countries, it is not appropriate in all areas of the world, he said.

“It is an expensive, complex and formidable machine, which has a long learning curve and is not readily available in developing countries,” Dr. Istiantoro said. His practice is based in Jakarta, Indonesia.

In phacofragmentation, the nucleus is divided into small fragments and then manually removed from the anterior chamber, Dr. Istiantoro said. The surgery is especially suited for the hard cataracts often seen in developing countries, he added.

In a prospective randomized study, Dr. Istiantoro divided 32 eyes into two equal groups, one undergoing phacoemulsification and the other phacofragmentation, to determine the procedures’ efficacy and safety in removal of mature white cataracts.

Postoperatively, the mean pupil diameter after IOL insertion was 7.72 mm in the phacofragmentation group and 7.82 mm in the phacoemulsification group. Mean corneal thickness at day 1 was 872 µm in the fragmentation group and 647 µm in the emulsification group. At day 1, the emulsification group demonstrated better uncorrected visual acuity, but at 1 week and 1 month the groups showed no significant differences, he said.

For more details on Dr. Istiantoro's phacofragmentation techniques, read the September 1 print edition of Ocular Surgery News U.S. Edition.