[Experiences with "reversed tip and snip" phacoemulsification].

Abstract

UNLABELLED: The endothelial cell count after phacoemulsification serves as a sensitive indicator for the level of corneal traumatization caused by different phacoemulsification techniques concerning the used phacotime and phacoenergy/s. PATIENTS: In a prospective and randomized study, the "reversed tip and snip" technique and the "divide and conquer" technique were performed in groups of 30 patients each. The corneal endothelial cell count was measured preoperatively as well as 4 weeks and 3 months postoperatively. In a second study the phacotime and phacoenergy used/second and the endothelial cell loss were compared between patients 1-30 and 31-60 who were operated on with the "reversed tip and snip" technique, demonstrating the learning curve of this technique. RESULTS: The endothelial cell count showed significant (P < 0.001) reduction by about 10% after the "reversed tip and snip" technique and by about 15% after the "divide and conquer" technique. The latter produced significantly greater cell loss. The phacotime (mean: 22-17) and phacoenergy/s (mean: 23-16) were reduced significantly (P < 0.05) when patients 1-30 were compared with 31-60. CONCLUSION: The "reversed tip and snip" phacoemulsification technique produces less endothelial cell loss than the "divide and conquer" technique. There is a short learning curve by using the "reversed tip and snip" technique.