Safety and effectiveness of a novel bimanual phaco chopping-fragmentation technique for retained intravitreal lens fragments

Purpose: To describe a new technique of phacofragmentation using a chopper and chandelier endoillumination. Materials and Methods:In 8 consecutive eyes, by the new technique, after completing vitrectomy in convention 3-port method, a chandelier illumination light source was used for illumination, a phaco-chopper was used in the non-dominant hand and the phacofragmatome in the dominant hand.This method was compared with 12 consecutive patients (12 eyes) receiving standard phacofragmentation.Results: Mean age at presentation between the two groups was comparable in demography, and presenting and postoperative vision as follows.Age: Standard method: mean age 69.66±12.01years (95% C.I. 62.86-76.46),New method: mean age 70.13±11.47years (95% C.I. 62.18-78.08),p=0.93 ); Mean pre-operative vision: Standard method-1.93±0.94log MAR, New method-1.97±0.86logMAR, p=0.9;Mean postoperative vision Standard method-0.55+ 0.16 logMAR, New method 0.53±0.12logMAR, p=0.7).The mean duration taken for completion of fragmentation was 3.27±0.87minutes, (95% C.I. 2.78-3.76minutes) and 1.91±0.66minutes, (95% C.I. 1.45-2.37minutes) p=0.0001 respectively.The mean foveal thickness on day 1 postoperative was 194±84 microns (95% C.I. 10.37-247.63 microns) and 210±62 microns (95% C.I. 149.49-230.51microns) respectively (p=0.62).Conclusion: Phacofragmentation using chandelier illumination, assisted with a chopper, is a safe and fast alternative technique to standard phaco-fragmentation.