EC Ophthalmology

Research Article Volume 14 Issue 8 - 2023

Effects of the Eight-Chop Technique in Phacoemulsification on Intraocular Pressure in Patients with Primary Open-Angle Glaucoma and Controls

Tsuyoshi Sato*

Department of Ophthalmology, Sato Eye Clinic, Chiba-ken, Japan

*Corresponding Author: Tsuyoshi Sato, Department of Ophthalmology, Sato Eye Clinic, Chiba-ken, Japan.
Received: July 16, 2023; Published: August 07, 2023



Purpose: To investigate the long-term effects of phacoemulsification by the eight-chop technique on intraocular pressure (IOP) in patients with primary open-angle glaucoma (POAG).

Methods: This study comprised the eyes of patients with cataracts who had undergone phacoemulsification and posterior chamber intraocular lens implantation. Patients with corneal disease or opacity, uveitis, pupillary dilation problem, and previous trauma or surgery were excluded. Cataract surgeries were performed using the eight-chop technique. The operative time, phaco time, aspiration time, cumulative dissipated energy, and volume of fluid used were measured intraoperatively. Best-corrected visual acuity, IOP and corneal endothelial cell density (CECD) were measured postoperatively at 7 and 19 weeks.

Results: In total, 150 eyes of 98 patients were followed up. The POAG group had a CECD loss rate of 1.5% and 1.2% at 7 and 19 weeks postoperatively, respectively. The control group had a CECD loss rate of 0.8% and 1.4% at 7 and 19 weeks postoperatively, respectively. The IOP reduction rate at 1 year postoperatively was 12.7% and 12.5% in the POAG and control groups, respectively. In the subgroups with preoperative IOP below 15 mmHg, IOP decreased significantly (p < .01, paired t-test) at 7 weeks and remained significantly lower at 1 year postoperatively.

Conclusion: The eight-chop technique remained effective in lowering IOP after 1 year in the POAG and control groups. This effect did not diminish in patients preoperative IOP below 15 mm Hg. Phacoemulsification using the eight-chop technique may be effective for patients with glaucoma.

Keywords: Cataract Surgery; Phacoemulsification; Primary Open-Angle Glaucoma; Intraocular Pressure; Eight-Chop Technique

  1. Elgin U., et al. “Early postoperative effects of cataract surgery on anterior segment parameters in primary open-angle glaucoma and pseudoexfoliation glaucoma". Turkish Journal of Ophthalmology 3 (2016): 95-98.
  2. Majstruk L., et al. “Long term effect of phacoemulsification on intraocular pressure in patients with medically controlled primary open-angle glaucoma". BMC Ophthalmology 1 (2019): 149.
  3. Damji KF., et al. “Intraocular pressure following phacoemulsification in patients with and without exfoliation syndrome: a 2 year prospective study". British Journal of Ophthalmology 8 (2006): 1014-1018.
  4. Melancia D., et al. “Cataract surgery and intraocular pressure". Ophthalmic Research 3 (2015): 141-148.
  5. Hayashi K., et al. “Effect of cataract surgery on intraocular pressure control in glaucoma patients". Journal of Cataract and Refractive Surgery 11 (2001): 1779-1786.
  6. Shingleton BJ., et al. “Three and five year changes in intraocular pressures after clear corneal phacoemulsification in open angle glaucoma patients, glaucoma suspects, and normal patients". Journal of Glaucoma 6 (2006): 494-498.
  7. Wirbelauer C., et al. “Intraocular pressure in nonglaucomatous eyes with pseudoexfoliation syndrome after cataract surgery". Ophthalmic Surgery, Lasers and Imaging Retina 6 (1998): 466-471.
  8. Shingleton BJ., et al. “Long-term changes in intraocular pressure after clear corneal phacoemulsification: normal patients versus glaucoma suspect and glaucoma patients". Journal of Cataract and Refractive Surgery 7 (1999): 885-890.
  9. Irak-Dersu I., et al. “Intraocular pressure change after temporal clear corneal phacoemulsification in normal eyes". Acta Ophthalmologica 1 (2010): 131-134.
  10. Jimenez-Roman J., et al. “Effect of phacoemulsification on intraocular pressure in patients with primary open angle glaucoma and pseudoexfoliation glaucoma". International Journal of Ophthalmology 9 (2017): 1374-1378.
  11. Poley BJ., et al. “Long-term effects of phacoemulsification with intraocular lens implantation in normotensive and ocular hypertensive eyes". Journal of Cataract and Refractive Surgery 5 (2008): 735-742.
  12. Salimi A., et al. “Matched cohort study of cataract surgery with and without trabecular microbypass stent implantation in primary angle-closure glaucoma". American Journal of Ophthalmology 1 (2021): 310-320.
  13. Iancu R and Corbu C. "Intraocular pressure after phacoemulsification in patients with uncontrolled primary open angle glaucoma". JML Journal of Medicine and Life 1 (2014): 11-16.
  14. Falck A., et al. “A four-year prospective study on intraocular pressure in relation to phacoemulsification cataract surgery". Acta Ophthalmologica 7 (2011): 614-616.
  15. Sato T. "Efficacy and safety of the eight-chop technique in phacoemulsification for cataract patients". Journal of Cataract and Refractive Surgery 5 (2023): 479-484.
  16. Akahoshi T. "Phaco Prechop”. Phaco Chop and Advanced Phaco Techniques. Editions. Chang DF. Thorofare: SLACK Incorporated 1 (2013): 55-76.
  17. Akahoshi T. "Phaco Prechop: re-evaluation of single-handed phacoemulsification using a new nucleofracture technique". Atarashii Ganka 9 (1999): 1219-1233.
  18. Emery JM. "Kelman phacoemulsification; patient selection”. Extracapsular Cataract Surgery. Eds. Emery JM and Mclyntyre DJ. St Louis: CV Mosby 1 (1983): 95-100.
  19. Miyata K., et al. “Efficacy and safety of the soft-shell technique in cases with a hard lens nucleus". Journal of Cataract and Refractive Surgery 9 (2002): 1546-1550.
  20. Sato M., et al. “Soft-shell technique using Viscoat and Healon 5: a prospective, randomized comparison between a dispersive-viscoadaptive and a dispersive-cohesive soft-shell technique". Acta Ophthalmologica 1 (2008): 65-70.
  21. Igarashi T., et al. “Effects of hydrogen in prevention corneal endothelial damage during phacoemulsification: a prospective randomized clinical trial". American Journal of Ophthalmology 1 (2019): 10-17.
  22. Helvacioglu F., et al. “Outcomes of torsional microcoaxial phacoemulsification performed by 12-degree and 22-degree bent tips". Journal of Cataract and Refractive Surgery 8 (2013): 1219-1225.
  23. Upadhyay S., et al. “Comparative evaluation of modified crater (endonucleation) chop and conventional crater chop techniques during phacoemulsification of hard nuclear cataracts: A randomized study". Indian Journal of Ophthalmology 3 (2022): 794-798.
  24. Park J., et al. “Comparison of phaco-chop, divide-and-conquer, and stop-and-chop phaco techniques in microincision coaxial cataract surgery". Journal of Cataract and Refractive Surgery 10 (2013): 1463-1469.
  25. Poley BJ., et al. “Intraocular pressure reduction after phacoemulsification with intraocular lens implantation in glaucomatous and nonglaucomatous eyes: evaluation of a causal relationship between the natural lens and open-angle glaucoma". Journal of Cataract and Refractive Surgery 11 (2009): 1946-1955.
  26. Alvarado J., et al. “Trabecular meshwork cellularity in primary open-angle glaucoma and nonglaucomatous normals". Ophthalmology 6 (1984): 564-579.
  27. Grierson I and Howes RC. "Age-related depletion of the cell population in the human trabecular meshwork". Eye 1 2 (1987): 204-210.
  28. Tektas OY and Lütjen-Drecoll E. "Structural changes of the trabecular meshwork in different kinds of glaucoma". Experimental Eye Research 4 (2009): 769-775.
  29. Fang CEH., et al. “Corneal endothelial cell density loss following glaucoma surgery alone or in combination with cataract surgery: a systematic review protocol". BMJ Open 9 (2021): e050992.
  30. Saini C., et al. “Glaucoma in patients with endothelial keratoplasty". Cornea 12 (2022): 1584-1599.

Tsuyoshi Sato. Effects of the Eight-Chop Technique in Phacoemulsification on Intraocular Pressure in Patients with Primary Open-Angle Glaucoma and Controls. EC Ophthalmology 14.8 (2023): 01-11.