Effectiveness of Phaco-chop, Stop&Chop, and the nitinol filament nuclear disassembly techniques for dense cataract removal.

PURPOSE: To compare the effectiveness and outcomes of three surgical techniques for dense cataract removal: Nitinol filament mechanical phaco-fragmentation (NFMP), Phaco-chop, and Stop&Chop by evaluating their impact on ultrasound energy consumption and key perioperative parameters.

METHODS

This is a single-center non-randomized retrospective study of patients with dense cataracts who underwent phacoemulsification using NFMP, Phaco-chop, or Stop&Chop techniques. The primary outcome was cumulative dissipated energy (CDE). Secondary outcomes included aspiration time, irrigation fluid usage, phacoemulsification time, endothelial cell loss, and postoperative inflammation. Patients with endothelial cell counts < 2,000 cells/mm2, pseudoexfoliation syndrome, uncontrolled glaucoma, zonular weakness, or prior ocular surgeries were excluded.

RESULTS

The study included 105 eyes, distributed across three groups. Mean CDE was lowest in the NFMP group (7.90±3.16), followed by Phacochop (9.25±3.13) and Stop&Chop (10.79±3.94); a statistically significant reduction was found between NFMP and Stop&Chop (p < 0.05). Mean phacoemulsification time with NFMP was significantly shorter (40.31±31.71 s) than with Phaco-chop (79.18±34.20 s) or Stop&Chop (80.84±36.76 s) (p < 0.01).

CONCLUSIONS

Mechanical phaco-fragmentation with NFMP achieved significantly lower energy consumption compared to Stop&Chop, with safety and fluidics comparable to those of conventional techniques. These findings align with the existing literature, which shows the benefits of NFMP in challenging cataract cases; however, the magnitude and significance of the effects may vary depending on patient selection and cataract complexity. CLINICAL TRIAL NUMBER: Not applicable.