A comparative study of divide and conquer, stop and chop and direct chop techniques of nucleotomy in topical phacoemulsification: an interventional study

Abstract

Based on population research, it has been found that more than 74% of elderly individuals in India have either undergone cataract surgery or have cataracts, and women are more likely than males to acquire cataracts. A cataract is one of the primary causes of blindness in India and around the world, but it's also the leading cause of avoidable blindness. There have been many advances in cataract surgery including advancements in surgical techniques and the availability of various intra-ocular lenses for better visual rehabilitation of the patient. Phacoemulsification is now one of the most commonly used surgical techniques for cataract extraction, it is done under local anesthesia or under topical anesthesia. As with all cataract surgeries, there is corneal decompensation even with phacoemulsification. Our study aims to compare three different nucleotomy approaches used for topical phacoemulsification: Divide & Conquer, Stop & Chop, and Direct Chop. We will assess which technique yields the best visual prognosis postoperatively, causes less corneal decompensation and has fewer complications. Specular microscopy will be used in patients who are to be operated for cataract extraction. Before the operation, we can use specular microscopy to determine the number of Corneal Endothelial cells and Central Corneal Thickness of the patient. Then, after the surgery, we can conduct another specular microscopy test to compare the techniques used for nucleotomy. This will help us determine which technique results in less loss of corneal endothelial cells and less reduction in central corneal thickness. Thus, we will use specular microscopy as a diagnostic tool and also a prognostic indicator in our study. Visual acuity of the patient will be measured preoperatively and again post operatively to compare which surgical technique achieves best visual rehabilitation for the patient.