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T. M. Haller, C. B. Haller, M. L. Haller; A Comparison of Corneal Endothelial Cells Loss Between One-Handed and Two-Handed Phacoemulsification Techniques. Invest. Ophthalmol. Vis. Sci. 2009;50(13):1146.
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To compare the difference of corneal endothelial cell loss between two phacoemulsification techniques: one-handed versus two-handed
A retrospective study was conducted on 384 corneas of eyes that underwent phacoemulsification cataract surgery. In 174 of the surgeries, the surgeon used a one- handed technique. The phacoemulsification handpiece was used to make 2 grooves in the nucleus to divide it into 3 or 4 pieces which were then phacoemulsified. In 210 procedures, the same surgeon utilized a 2-handed technique. A single groove was made in the nucleus and the second instrument was used to help guide and chop the segments into smaller fragments. The Konan Specular Microscope SP-4000 was used to obtain corneal endothelial cell densities prior to cataract surgery and then again, three months postoperatively. The results were then calculated into a percentage loss, after which the outcomes in the 2 surgical groups were compared
Corneas in the two-handed phacoemulsification group demonstrated less endothelial cell loss as compared to the one-handed group. The average cell loss in the one-handed group was 33.8%, while the two-handed group averaged a loss of 16.94%
Corneal endothelial cell loss during phacoemulsification surgery can be significantly minimized by utilizing a two-handed technique, rather than a one-handed one. Surgeons should consider this difference when deciding which surgical technique they are going to use, particularly in patients with preoperative corneal endothelial pathology, hard nuclei or other complicated conditions
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