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.

Design: Prospective non-comparative interventional clinical study.

Participants: 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.

KEYWORDS::

• mature cataract
• sharp chopper
• topical anesthesia
• horizontal chopping
• phacoemulsification

ACKNOWLEDGMENT

Presented in part at ESCRS Berlin 2008. We thank Romanti Kardono, MD (Jakarta, Indonesia), for editing the language of the article before submission.

Declaration of Interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.