الفهرس 
Introduction
The phaco machineOnly 14 pages are availabe for public view
 |  | from | 150 |  |  |
| | | from | 150 | | |
Abstract
This prospective study was carried out on 60 eyes of 60 patients having senile nuclear cataract selected randomly from patients attending the ophthalmic outpatient clinic of Mansoura Ophthalmology Center during the period from January 2009 to July 2010. The aim of the study was to evaluate the efficacy and safety of ”divide and conquer” versus ”chop” phacoemulsification techniques (phaco-chop and stop-and-chop techniques). Patients were divided into 3 groups: • Group I included 30 eyes (30 patients) that underwent divide and conquer phacoemulsification technique. • Group II included 15 eyes (15 patients) that underwent stop and chop phacoemulsification technique. • Group III included 15 eyes (15 patients) that underwent phaco chop phacoemulsification technique. After history taken, preoperative detailed ophthalmologic examination was performed including visual acuity measurement, slit lamp biomicroscopy, tonometry and fundus examination. The following investigations were done: • Central endothelial cell density measurement using specular microscopy. • Central corneal thickness (CCT) measurement using specular microscopy. • Assessment of nuclear density using Lens Opacities Classification System III (LOCS III). Phacoemulsification using Oertli CataRhex machine was done for all case using 3 techniques (divide-and-conquer for group I, stop-and-chop for group II and phaco-chop for group III). The following parameters were recorded; the phaco time and the phaco power, operative complications. The total US energy (APT) was calculated by multiplying the phaco time (seconds) by the phaco power (%). All cases were followed up for 3 months postoperatively. Four visits were arranged for every case at day, week, month and 3 months postoperative intervals. In each visit the following were don foe every case: • Complete ophthalmic examination. • Specular microscopy for endothelial cell density and central corneal thickness measurement. • Anterior segment photographing using Sony digital camera attached to the slit lamp. The mean APT was significantly lower in groups II and III (20.2and 15.2) than in group I (29.8). The difference in APT means between group II and group III did not reach statistical significance. There was statistically significant endothelial cell loss following all studied techniques at 3 months postoperatively (12.4%, 10.5% and 9.7%, in groups I, II, III, respectively). There was no significant difference between all studied groups. The nuclear grade and APT had positive correlation with higher ECL while the age, sex and axial length did not affected ECL. Significant increase in the CCT was observed at the immediate postoperative day among the 3 studied groups (6.8%, 6.2% and 5.7%, respectively). There was no statistically significant difference between the 3 groups. The postoperative CCT pachymetry values were returned to near preoperative values at one month postoperatively. All studied groups showed significant improvement in visual acuity with earlier visual improvement following stop and chop and phaco chop techniques. Best corrected visual acuity more than 6/9 was achieved in 76.7% in group I, 83% in group II and 86.7% in group III. The incidence of operative complications was low in all studied groups.