Comparison between the prechopping method with a reverse chopper and the routine stop-and-chop method in treating cataract with grade IV hard nucleus.

The aim of this study was to compare the safety and efficacy between the prechopping method using a Reverse Chopper (iHPC) and the routine stop-and-chop (RSC) method in phacoemulsification of cataracts with grade IV hard nuclei (HNC (≥IV)). A total of 32 patients (32 eyes) scheduled for Phaco combined with intraocular lens (Phaco-IOL) for HNC (≥IV) from March 2015 to January 2016 were enrolled and randomly divided into two groups (the iHPC group, n=16 and the RSC group, n=16) so as to compare the effective intraoperative Phaco time, corneal edema 1-3 days after surgery, best corrected visual acuity (BCVA), and rate of loss of corneal endothelial cells (CECs) 1 month after surgery. The effective intraoperative Phaco time in the iHPC group was shorter (42.56s vs. 78.63s, P=0.000), the degree of corneal edema 1-3 days after surgery was less (P<0.01), the ratio of cases with BCVA>0.6 was higher, and the CEC loss rate was lower (13.36±2.85% vs. 25.77±3.81%, P=0.000). Compared with RSC, iHPC can reduce CEC injury in Phaco surgery, and the patients can recover their vision faster.