title: Double extra sharp chopper increase efficacy of phacoemulsification for hard mature cataract surgery.
abstract: OBJECTIVE
  To assess the efficacy and safety of a modified double extra sharp chopper for removal of hard cataracts.
  
  
  METHODS
  Prospective non-comparative interventional clinical study.
  
  
  METHODS
  Forty eyes from 25 patients with hard mature cataract grades 3-4.
  
  
  METHODS
  The pre-modified Koch chopper was sharpened under the slit lamp to become extra sharp at the tip and inside the edge and 2 mm in length. Patients with hard mature cataract grades 3-4 (grade 4 being the hardest) underwent phacoemulsification by single surgery and were analyzed prospectively.
  
  
  RESULTS
  The mean effective phaco time was 23.73 +/- 5.75 seconds. Minimal power was facilitated by using horizontal chopping using a self-made double extra sharp chopper. No resistance was encountered while moving the chopper, regardless of cataract persistency. Preoperative BCVA were count fingers (47%), hand movement (35%), and light perception (18%). Postoperative BCVA on day 1and day 7 were 0.57 and 0.95, respectively. There was no difference of effective phaco time among nuclear hardness (P = 0.467), which represent the effectiveness of the extra sharp chopper.
  
  
  CONCLUSIONS
  The double extra sharp chopper facilitated a safe and rapid visual rehabilitation and maximal subject comfort when doing phacoemulsification for hard mature cataracts.
authors.affiliation: Department of Ophthalmology Faculty of Medicine, Christian University of Indonesia, Jakarta, Indonesia, and Cikini CCI Hospital Jakarta, Indonesia. retinaid@yahoo.com
authors.forename: Gilbert W S
authors.initials: GW
authors.lastname: Simanjuntak
authors.forename: Jannes F
authors.initials: JF
authors.lastname: Tan
authors.forename: H H B
authors.initials: HH
authors.lastname: Mailangkay
mesh_terms: D000368:Aged; D002386:Cataract / Q000473:pathology; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000295:instrumentation* / Q000379:methods*; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014786:Vision Disorders / Q000534:rehabilitation; D014792:Visual Acuity / Q000502:physiology