EC Ophthalmology

Research Article Volume 15 Issue 1 - 2024

Efficacy and Safety of the Eight-Chop Technique in Phacoemulsification for White Cataract

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: November 06, 2023; Published: December 15, 2023



Purpose: To evaluate the safety and efficacy of the eight-chop technique in phacoemulsification for white cataracts.

Methods: The lens capsule was stained with brilliant blue G (BBG) and nucleus was cracked using the Eight-chopper. The best-corrected visual acuity (BCVA), corneal endothelial cell density (CECD), and intraocular pressure (IOP) were evaluated. The primary outcome measures were the mean operative time, mean phaco time, aspiration time, cumulative dissipated energy (CDE), and volume of fluid used.

Results: The lens capsule visualization was sufficient with BBG. The mean (standard deviation, SD) operative time was 11.40 ± 4.42 minutes. The mean (SD) phaco time was 31.4 ± 15.3 seconds. The corresponding values for aspiration time, CDE, and volume of fluid used were 2.50 ± 0.72 minutes, 12.12 ± 7.07, and 61.9 ± 15.8 mL, respectively. The BCVA improved significantly (p < 0.01). The CECD decreased by 5.5% at 7 weeks and 3.7% at 19 weeks postoperatively. The rate of IOP reduction was 7.3% at 7 weeks and 9.5% at 19 weeks postoperatively.

Conclusion: The eight-chop technique is safe and effective in phacoemulsification and may reduce postoperative CECD loss and lower IOP in eyes with white cataracts. BBG staining may be safe for corneal endothelial cells.

 Keywords: Cataract Surgery; Phacoemulsification; White Cataract; Corneal Endothelial Cell; Eight-Chop Technique

  1. Akahoshi T. "Phaco Prechop”. Phaco Chop and Advanced Phaco Techniques. Eds. Chang DF. Vol. Thorofare: SLACK Incorporated (2013): 55-76.
  2. Akahoshi T. "Phaco Prechop: Re-evaluation of single-handed phacoemulsification using a new nucleofracture technique". Atarashii Ganka9 (1999): 1219-1233.
  3. Sato T. "Efficacy and safety of the eight-chop technique in phacoemulsification for cataract patients”. Journal of Cataract and Refractive Surgery5 (2023): 479-484.
  4. Sato T. "Effects of the eight-chop technique in phacoemulsification on intraocular pressure in patients with primary open-angle glaucoma and controls". EC Ophthalmology8 (2023): 1-11.
  5. Jacob S., et al. “Trypan blue as an adjunct for safe phacoemulsification in eyes with white cataract". Journal of Cataract and Refractive Surgery10 (2002): 1819-1825.
  6. Chakrabarti A and Singh S. "Phacoemulsification in eyes with white cataract". Journal of Cataract and Refractive Surgery7 (2000): 1041-1047.
  7. Hisatomi T., et al. “Staining ability and biocompatibility of brilliant blue G: Preclinical study of brilliant blue G as an adjunct for capsular staining". Archives of Ophthalmology4 (2006): 514-519.
  8. Ermisş SS., et al. “Comparing the efficacy and safety of phacoemulsification in white mature and other types of senile cataracts". British Journal of Ophthalmology11 (2003): 1356-1359.
  9. Wong VW., et al. “Safety and efficacy of micro-incisional cataract surgery with bimanual phacoemulsification for white mature cataract". Ophthalmologica 1 (2007): 24-28.
  10. Venkatesh R., et al. “Phacoemulsification versus manual small-incision cataract surgery for white cataract". Journal of Cataract and Refractive Surgery11 (2010): 1849-1854.
  11. Emery JM. "Kelman phacoemulsification; patient selection”. Extracapsular Cataract Surgery. Eds. Emery JM and Mclyntyre DJ. Vol. St Louis: CV Mosby, (1983): 95-100.
  12. Gimbel HV and Willerscheidt AB. "What to do with limited view: The intumescent cataract". Journal of Cataract and Refractive Surgery5 (1993): 657-661.
  13. Miyata K., et al. “Efficacy and safety of the soft-shell technique in cases with a hard lens nucleus". Journal of Cataract and Refractive Surgery9 (2002): 1546-1550.
  14. Helvacioglu F., et al. “Outcomes of torsional microcoaxial phacoemulsification performed by 12-degree and 22-degree bent tips". Journal of Cataract and Refractive Surgery8 (2013): 1219-1225.
  15. 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.
  16. Abdelmotaal H., et al. “Comparison of the phaco chop and drill-and-crack techniques for phacoemulsification of hard cataracts: A fellow eye study". Acta Ophthalmologica 3 (2021): e378-e386.
  17. 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 Surgery10 (2013): 1463-1469.
  18. Storr-Paulsen A., et al. “Endothelial cell damage after cataract surgery: Divide-and-conquer versus phaco-chop technique". Journal of Cataract and Refractive Surgery6 (2008): 996-1000.
  19. Helvacioglu F., et al. “Comparison of two different ultrasound methods of phacoemulsification". American Journal of Ophthalmology 2 (2014): 221-226.e221.
  20. Igarashi T., et al. “Effects of hydrogen in prevention of corneal endothelial damage during phacoemulsification: A prospective randomized clinical trial". American Journal of Ophthalmology 207 (2019): 10-17.
  21. Bourne RR., et al. “Effect of cataract surgery on the corneal endothelium: Modern phacoemulsification compared with extracapsular cataract surgery". Ophthalmology4 (2004): 679-685.
  22. 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.
  23. Kosrirukvongs P., et al. “Corneal endothelial changes after divide and conquer versus chip and flip phacoemulsification". Journal of Cataract and Refractive Surgery7 (1997): 1006-1012.
  24. Díaz-Valle D., et al. “Endothelial damage with cataract surgery techniques". Journal of Cataract and Refractive Surgery7 (1998): 951-955.
  25. Vasavada A., et al. “Phacoemulsification of white mature cataracts". Journal of Cataract and Refractive Surgery2 (1998): 270-277.
  26. Vajpayee RB., et al. “Phacoemulsification of white hypermature cataract". Journal of Cataract and Refractive Surgery8 (1999): 1157-1160.
  27. Enaida H., et al. “Quantitative analysis of vitreous and plasma concentrations of brilliant blue g after use as a surgical adjuvant in chromovitrectomy". Retina10 (2013): 2170-2174.
  28. Ueno A., et al. “Biocompatibility of brilliant blue G in a rat model of subretinal injection". Retina4 (2007): 499-504.
  29. Baba T., et al. “Comparison of vitrectomy with brilliant blue G or indocyanine green on retinal microstructure and function of eyes with macular hole". Ophthalmology12 (2012): 2609-2615.
  30. Takayama K., et al. “Phototoxicity of indocyanine green and Brilliant Blue G under continuous fluorescent illumination on cultured human retinal pigment epithelial cells". Investigative Ophthalmology and Visual Science 11 (2012): 7389-7394.
  31. Irak-Dersu I., et al. “Intraocular pressure change after temporal clear corneal phacoemulsification in normal eyes". Acta Ophthalmologica 1 (2010): 131-134.
  32. Steuhl KP., et al. “Intraocular pressure and anterior chamber depth before and after extracapsular cataract extraction with posterior chamber lens implantation". Ophthalmic Surgery 4 (1992): 233-237.
  33. Tennen DG and Masket S. "Short-and long-term effect of clear corneal incisions on intraocular pressure". Journal of Cataract and Refractive Surgery5 (1996): 568-570.
  34. Chen PP., et al. “The effect of phacoemulsification on intraocular pressure in glaucoma patients: A report by the American Academy of Ophthalmology". Ophthalmology 7 (2015): 1294-1307.
  35. Brazitikos PD., et al. “Ultrasonographic classification and phacoemulsification of white senile cataracts". Ophthalmology11 (1999): 2178-2183.

Tsuyoshi Sato., et al. "Efficacy and Safety of the Eight-Chop Technique in Phacoemulsification for White Cataract." EC Ophthalmology 15.1 (2024): 01-10.