To compare the four different cracking techniques in brown coloured cataract during cataract surgery by machine

Not yet recruiting

Brief Summary: Performing Phacoemulsification in brown cataracts has many challenges with a high complication rate even in experienced hands. In brunescent cataract, the hard, unyielding leathery fibres of the lens nucleus poses a great difficulty to perform phacoemulsification. Hence many variations in the nucleotomy techniques is also being practiced with an aim to achieve an uneventful and safe outcome.

Thus use of safer phaco techniques that will significantly reduce the phaco time and energy and consequential corneal endothelial cell loss can be more rewarding for both the patient and surgeon because of profound restoration of vision and a successful outcome. Hence this study is undertaken, to compare the four nucleotomy techniques (Divide and Conquer, Stop and Chop, Horizontal Chop and Vertical Chop) in terms of its intraoperative paratemeters like (phaco time and phaco energy), the corneal endothelial parameters (cell density, coefficient of variation and central corneal thickness) and visual acuity.

Recruitment & Eligibility

Inclusion Criteria

1.Patients with brunescent cataract.
(nuclear opalascence (NO) grade 6 according to LOCS III classification) 2.Patients belonging to age group >50 years.

Exclusion Criteria

1.Specular microscopy counts less than 2000 cells/mm2 2.Small pupil (less than 3mm) 3.Pseudoexfoliation 4.Shallow anterior chamber depth (less than one fourth the corneal thickness), as according to Van Herickâ€™s grading of peripheral anterior chamber depth.
5.Corneal disorders like corneal opacity, degenerations and dystrophies.
6.Subluxated/traumatic cataract 7.Ocular inflammation 8.Coexisting retinal pathologies or undergone previous retinal surgeries.

Primary Outcome Measures

Name	Time	Method
1. To record in all the four nucleotomy techniques, the intraoperative parameters such as	On the day of presentation and follow up at 1 week and 1 month postoperatively
a)Mean phaco time (min)	On the day of presentation and follow up at 1 week and 1 month postoperatively
b)Mean phaco power (%)	On the day of presentation and follow up at 1 week and 1 month postoperatively
c)Effective Phaco Time (EPT)	On the day of presentation and follow up at 1 week and 1 month postoperatively
2. To compare the endothelial parameters like cell density, Coefficient of variation (CV) and central corneal thickness (CCT) before and after the surgery in each of these techniques.	On the day of presentation and follow up at 1 week and 1 month postoperatively

Secondary Outcome Measures

Name	Time	Method
To record visual acuity	On the day of presentation and at 1 week and 1 month postoperatively

Locations (1): Sankara Eye Hospital
🇮🇳
Guntur, ANDHRA PRADESH, India
Sankara Eye Hospital
🇮🇳Guntur, ANDHRA PRADESH, India
Dr M Madhumita
Principal investigator
8500408079
drmmadhumita@gmail.com