A Counter Prechop Technique Using a Modified Universal Prechopper in Combination with or without Using a Universal Chopper

Hyungil Kim,1 Younghoon Jung,2 Mikio Inamura3 1Gyeongju St. Mary’s Eye Clinic, Gyeongju, Republic of Korea; 2Department of Ophthalmology, Pohang Naval Hospital, Pohang, Republic of Korea; 3Inamura Eye Clinic, Yokohama, JapanCorrespondence: Mikio Inamura, Inamura Eye Clinic, 5-125 Isesakicho, Naka-ku, Yokohama, Kanagawa, 231-0045, Japan, Email m-ina@sa2.so-net.ne.jpPurpose: To introduce an alternative prechop technique without or with the use of a modified universal chopper (AE-2591, HI Kim chopper, ASICO, Inc. USA).Methods: Patients who underwent cataract surgery using the phaco-chop technique and the modified prechop technique have been grouped and reviewed retrospectively. Endothelial cell count (ECC) and central corneal thickness (CCT) measured 7 days pre-operatively, and 1 month and 3 months post-operatively, were compared between the two groups. In modified prechop technique, a narrow 1.7 mm neck prechopper (AE-4298, HI Kim-Inamura chopper, ASICO, Inc., USA) was used with universal chopper (AE-2591, HI Kim chopper, ASICO, Inc., USA) as an additional device for grade 4 and above cataracts or without it for grade 2 to 3 cataracts. Details of the surgical technique is further described in the Method section.Results: A total of 104 eyes in the modified prechop group and 97 eyes in the phaco-chop group were enrolled in the study. Pre-operative nuclear opacity, ECC, and CCT as well as post-operative ECC (absolute value and the loss) and CCT (absolute value and the change) throughout the follow-up between the two groups did not show statistically significant differences.Conclusion: Counter prechop technique using the modified prechopper and universal chopper is a safe, easy, and versatile surgical technique that can be applied broadly in a wide range of cases with various complexities, including LOCS lll N1 to N6 nuclei, hypermature cataracts, small pupils, and fragile suspensory zonular ligaments, with post-operative result not inferior to that of the conventional technique.Keywords: prechop, counter prechop, ...