title: Comparison of phaco-chop, divide-and-conquer, and stop-and-chop phaco techniques in microincision coaxial cataract surgery.
abstract: OBJECTIVE
  To compare the outcomes of coaxial microincision cataract surgery (MICS) performed with 3 phacoemulsification techniques (phaco-chop, divide-and-conquer, and stop-and-chop) according to cataract density.
  
  
  METHODS
  Bucheon St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, South Korea.
  
  
  METHODS
  Prospective randomized clinical trial.
  
  
  METHODS
  Eyes with nuclear density from grade 2 to 4 were randomly subdivided into 3 groups (phaco-chop, divide-and-conquer, and stop-and-chop). Intraoperative measurements included ultrasound time (UST), mean cumulative dissipated energy (CDE), and balanced salt solution use. Clinical measurements included preoperative and 1 day, 1 month, and 2 month postoperative corrected distance visual acuity, central corneal thickness, and endothelial cell count.
  
  
  RESULTS
  Intraoperative measurements showed significantly less UST, CDE, and balanced salt solution use with the phaco-chop technique than with the divide-and-conquer and stop-and-chop techniques in the grade 4 cataract density group (P<.05). The percentage of endothelial cell loss was significantly lower in the phaco-chop group than in the divide-and-conquer and stop-and-chop groups in the grade 4 cataract density group 2 months after cataract surgery (P<.05).
  
  
  CONCLUSIONS
  All 3 techniques may be effective for coaxial MICS in mild and moderate cataracts. However, in eyes with hard cataract having coaxial MICS, the phaco-chop technique can be more effective for lens removal, with less corneal endothelial damage, than the divide-and-conquer and stop-and-chop techniques.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: From the Department of Ophthalmology & Visual Science (Park, Yum, M.S. Kim, E.C. Kim), College of Medicine, Catholic University of Korea, Seoul, South Korea; the Department of Ophthalmology (Harrison), College of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: Juwan
authors.initials: J
authors.lastname: Park
authors.forename: Hae Ri
authors.initials: HR
authors.lastname: Yum
authors.forename: Man Soo
authors.initials: MS
authors.lastname: Kim
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Harrison
authors.forename: Eun Chul
authors.initials: EC
authors.lastname: Kim
mesh_terms: D000085:Acetates / Q000627:therapeutic use; D000368:Aged; D002386:Cataract / Q000473:pathology*; D002452:Cell Count; D004338:Drug Combinations; D004728:Endothelium, Corneal / Q000473:pathology; D006801:Humans; D019654:Lens Implantation, Intraocular; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D008903:Minerals / Q000627:therapeutic use; D018918:Phacoemulsification / Q000379:methods*; D011446:Prospective Studies; D012965:Sodium Chloride / Q000627:therapeutic use; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000085:Acetates; C030660:BSS solution; D004338:Drug Combinations; D008903:Minerals; D012965:Sodium Chloride