Effects of phacoemulsification time on the corneal endothelium using phacofracture and phaco chop techniques

Purpose: To quantitatively assess early postoperative endothelial damage caused by two phacoemulsification techniques and to ascertain the effect of differences in phacoemulsification time. Setting: Department of Ophthalmology, Umberto Hospital, Lugo, Italy. Methods: This prospective study evaluated 100 patients who had phacoemulsification using one of two techniques: phaco chop (n = 50) or four-quadrant, divide and conquer phacofracture (n = 50). The endothelium of both groups was analyzed preoperatively and 8 weeks postoperatively by specular microscopy. Results: Phaco chop led to significantly shorter phacoemulsification time and less endothelial damage. Mean equivalent phacoemulsification time was 25.53 seconds +/- 11.26 (SD) in the phaco chop group and 87.26 +/- 48.03 seconds in the phacofracture group. Endothelial cell loss was 4.72 +/- 1.2% and 13.80 +/- 4.3%, respectively. Conclusion: The phaco chop technique led to shorter phacoemulsification time and less endothelial cell loss.