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lakehal-ayat youcef, Christophe Goetz, George Hayek, Marie-Soline LUC, Jean-Charles Vermion, Nadia Ouamara, Jean-Marc Perone; Phacoemulsification: subluxation versus divide and conquer in Beginner Surgeon. Invest. Ophthalmol. Vis. Sci. 2018;59(9):441.
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© ARVO (1962-2015); The Authors (2016-present)
To compare two techniques in cataract surgery in beginner Surgeon: crystalline subluxation versus divide and conquer.
Single-centric, prospective study in multivariate analysis, including 228 eyes of 228 patients undergoing cataract surgery between January 2015 and November 2017. The inclusion criteria were: middle-grade senile cataract (grade N2C2), operated under topical anesthesia, with an implant power of 21 diopters (+/- 3D). The beginner’s surgeons were all ophthalmology residents. Were collected the following data: US ultrasound power (%), ultrasound TPA (s) time, effective phacoemulsification time TPE (s) and operating time (min). Intraoperative pain rated from 0 to 6, as well as posterior capsular rupture rate. Two groups were compared according to the surgical method: subluxation (group 1) and divide and conquer (group 2).
Group 1 consisted of 123 patients and group 2 consisted of 107 patients. The mean age was 77 years (SD 8) in group 1 and 79 years (SD 6) in group 2. There were 77 (63%) men in group 1 and 73 (68%) in group 2. The average US power was 11.0% (SD 3.6) in group 1 versus 9.4% (SD 4.0) in group 2 (p = 0.002). Mean TPA was 79s (SD 34.2) in group 1 versus 84.7s (SD 28.6) in group 2 (p = 0.200). Mean TPE was 9.2s (SD 5.8) in group 1 versus 8.6s (SD 5.2) in group 2 (p = 0.001). The operating time was 14 min (SD 3) in group 1 versus 17min (SD 3) in group 2 (<0.001). There were 5 capsular breaks in group 1 and 9 in group 2 (p = 0.25). The mean pain score was 1.9 (SD 1.2) in group 1, and 2.3 (SD 1.3) in group 2 (p = 0.05).
the technique of lens subluxation in cataract surgery in beginner surgeons is associated with the use of a larger amount of ultrasound, and a shorter operating time, a less significant pain felt for the patient, without increasing the rate of posterior capsular rupture.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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