Purpose: To compare manual phacofracture and phacoemulsification techniques.
Setting: Dr. Rajendra Prasad Centre for Ophthalmic Sciences, New Delhi, India.
Methods: This prospective, randomized study comprised 60 cases of age-related cataract randomly divided into 2 groups: 30 eyes had phacoemulsification and 30, manual phacofracture using a trisection technique. Postoperative evaluation was at I day, 1 and 6 weeks, and 3 months. The parameters evaluated were amounts of viscoelastic material and irrigating fluid used, the time required to manage the nucleus postoperative best corrected visual acuity, endothelial cell loss, and complications.
Results: Mean viscoelastic material used intraoperatively (3.69 mL -± 0.81 [SD] versus 1.76 ± 0.54 mL) and the time required to manage the nucleus (7.78 ± 2.07 minutes versus 2,53 ± 1.18 minutes) were significantly greater in the phacofracture than in the phacoemulsification group, respectively. Best corrected visual acuity was significantly better in the phacoemulsification group on the first postoperative day; 64% had a visual acuity of 6/9 or better versus 37% in the phacofracture group. Endothelial cell loss at 3 months was 17.66 ± 3.65% in the phacofracture group and 12.03 ± 3.06% in the phacoemulsification group and central corneal edema persisting for more than 1 week, 7 and 0 cases, respectively. The differences between groups were statistically significant.
Conclusion: More experience in and further modification of the manual phacofracture technique are’ required before it can be recommended as a safe alternative to phacoemulsification.