Comparison between two-hole-assisted phaco-chop and stop-and-chop techniques for nuclear disassembly in residents’ cataract surgery

Abstract

Abstract PURPOSE: The purpose of this study was to evaluate the safety of the novel two-hole-assisted phaco-chop technique as a transition between stop-and-chop and direct-chop techniques and to compare its phacoemulsification parameters with the stop-and-chop technique. METHODS: A prospective quasi-experimental study was conducted at Al-Shifa Trust Eye Hospital, Rawalpindi, Pakistan. One hundred and three patients (103 eyes), aged 18 years and above, with nuclear sclerosis (NS)+2, NS +3, +4, cortical, and posterior subcapsular cataracts (WHO Cataract Grading Group) were included, whereas patients with uveitis, glaucoma, traumatic cataracts, small pupils, zonular weakness, lens subluxation, small palpebral fissures, soft cataracts (NS + 1), and posterior polar cataracts were excluded from the study. The stop-and-chop technique was performed in 58 (56.3%) patients, whereas the two-hole-assisted chop technique in the rest. Ultrasound time (UST), total surgical time, and volume of balanced salt solution (BSS) delivered were recorded. RESULTS: The mean age of the participants was 65.12 ± 8.85 years. The comparison of the two techniques revealed no statistically significant difference in the UST (P = 0.723), volume of BSS used (P = 0.102), and total surgery time (P = 0.517). However, a significant positive correlation between cataract grade and UST (Spearman’s r = 0.888, P < 0.001), BSS volume delivered (Spearman’s r = 0.831, P < 0.001), and surgery time (Spearman’s r = 0.846, P < 0.001) was observed. Moreover, the UST comparison between cataract grades revealed a significant difference between the three groups (F = 185.09 P < 0.001). P < 0.05 was considered statistically significant. CONCLUSION: The two-hole-assisted phaco chop is a safe and efficient transitional technique between stop-and-chop and direct-chop techniques for nuclear disassembly in cataract surgery performed by resident surgeons. In addition, the phacoemulsification parameters of the two-hole-assisted chop technique are comparable with the stop-and-chop technique.