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Jacob Reynolds, David McCartney, Derek Han, Clint Gregg, James Lee, Catherine Reppa; Comparison of Divide-and-Conquer and Endocapsular Disassembly Methods in Preserving Endothelial Count. Invest. Ophthalmol. Vis. Sci. 2019;60(9):2056. doi: https://doi.org/.
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To determine if endocapsular disassembly technique is better than the divide-and-conquer technique in preserving endothelial cell count during phacoemulsification and cataract extraction.
This is a prospective study performed at the Ophthalmology Eye Center at Texas Tech University Health Sciences Center (TTUHSC), Lubbock, TX and University Medical Center (UMC) Outpatient Surgery Center, Lubbock, TX. Phacoemulsification was performed in two groups (Divide-and-Conquer and Endocapsular Disassembly) with 100 cases recruited (50 cases from each of the two techniques). Primary outcome measurement will be 8-month post-operative endothelial cell count measured with noninvasive specular microscopy. Secondary outcome measurement will be 8-month post-operative best corrected visual acuity. Intra-operative measurements obtained include cumulative dissipated energy and amount of balanced salt solution (BSS).
Preliminary results based on 52 eyes show similar pre-operative endothelial cell counts between the two groups (P=0.59) and significantly more cumulative dissipated energy used with the endocapsular disassembly technique than with the divide-and-conquer technique (P<0.01), At 8 month follow-up, two cases from the endocapsular disassembly group show an average of 2.38 percent of endothelial cells lost and five cases from the divide-and-conquer group show an average of 16.39 percent of endothelial cells lost.
Preliminary data suggests less endothelial cell loss in the endocapsular disassembly group despite higher cumulative dissipated energy used intra-operatively. We will present 8-month follow-up data for the remaining cases at completion of data collection.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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