Assessment of Different Techniques of Nucleotomy during Phacoemulsification: A Comparative Study

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Abstract (English)

Abstract Aim: The aim of the present study was to compare different techniques of nucleotomy during phacoemulsification with respect to corneal endothelial cell loss, central corneal thickness (CCT). Methods: A comparative analysis on corneal endothelial cell loss and central corneal thickness was done in 90 patients undergoing cataract extraction by phacoemulsification in Department of Ophthalmology .These 90 patients were randomly divided into three groups of 30 each who underwent a different method of nucleotomy during phacoemulsification and were operated by the same surgeon. Results: The maximum number of patients was in Group A, 17 patients were in the age group of 61-70 years while most of the patients, 18 in Group B and 21 in Group C, were in the age group of 51 – 60 years. The mean age of patients in Groups A, B and C were 60.65 years, 61.25 years and 59.45 years respectively. There were more females and most of the patients belonged to NS grade I. The maximum number of patients in each group: 11 patients in Group A had visual acuity of 6/36 preoperatively, 14 patients in Group B and 16 patients in Group C had visual acuity of 6/60 preoperatively. No statistically significant difference was found in mean endothelial cell density in Group A, B and C preoperatively. No statistically significant difference was found in mean central corneal thickness in Group A, B and C preoperatively, and at 1st, 4th and 12th postoperative week. It was observed that CCT after 4 weeks of cataract surgery was not much different from preoperative value in all three groups. No patient of any group had BCVA of less than 6/36 on Snellen’s distance visual acuity chart with spectacles correction.  Conclusion: All three techniques of nucleotomy in phacoemulsification i.e divide & conquer, stop and chop and direct phaco chop are equally efficacious. The degree of endothelial cell loss and central corneal thickness changes in all three methods are almost similar in the hands of an experienced surgeon.