Stepwise Grooving Technique In Hard Cataract

To evaluate the safety and efficacy of a new stepwise grooving technique in hard cataract.

  20 eyes of 20 patients aged 60-80 years old with hard cataract (Grade III and IV; lens opacity classification system(LOCS)) underwent phacoemulsification. Stepwise grooving technique entailed initial grooving of the nucleus in stepwise configuration (two parallel vertical grooves and a connecting horizontal groove in between). After deepening; the nucleus could be separated into two halves by placing the chopper and phacoprobe in the corresponding right angles created between the vertical and horizontal grooves. Outcome measures included BCVA, Specular changes, Corneal edema, US power used, intraoperative and postoperative complications.

This was a prospective interventional study. BCVA one month postoperatively ranged from 0.5-0.2 in LogMAR, average 0.25. Fifteen eyes showed clear cornea from the second postoperative day. Five eyes had mild corneal edema resolved by conservative treatment within two weeks. Comparison with nearly matched group which underwent conventional divide and conquer technique revealed that there were statistically insignificant difference between both groups as regards BCVA, endothelial changes, intraoperative and postoperative complications.

Stepwise grooving as a novel technique is a safe and as effective as conventional divide and conquer technique in hard cataract.