Study: Endothelial cell damage similar using phaco chop or divide-and-conquer technique

Surgeons can expect to observe similar low corneal endothelial cell damage in patients after performing cataract surgery using the phaco chop or divide-and-conquer nuclear fracturing technique, a prospective study by researchers in Denmark suggests.

Allan Storr-Paulsen, MD, and colleagues at Frederiksberg University Hospital compared endothelial cell damage after performing phaco on 30 eyes of 30 patients using the phaco chop technique and 30 eyes of 30 patients using the divide-and-conquer technique. The surgeons recorded intraoperative phaco time, phaco power, irrigation volume and grade of nuclear firmness; endothelial cell density, variations in endothelial cell size, percentage of hexagonal cells and central corneal thickness were recorded at baseline and 3 and 12 months postoperatively.

While significantly less phaco power was used during phaco chop surgery than during divide-and-conquer surgery, both techniques yielded identical decreases in postoperative cell density, according to the study.

The investigators reported no statistically significant changes in variation in endothelial cell size, percentage of hexagonal cells or central corneal thickness.

In addition, visual acuity significantly increased identically in both groups, the authors noted.

"Higher endothelial cell loss was significantly correlated with shorter axial length," they said.

The study is published in the June issue of Journal of Cataract & Refractive Surgery.