COMPARISON OF PAIN PERCEPTION IN CATARACT SURGERY WITH PHACO- HORIZONTAL-CHOP TECHNIQUE VERSUS VERTICAL-CHOP TECHNIQUE IN GRADE 3 CATARACT

Authors

  • Imam Masduki Ahmad Dahlan University
  • Dwi Ditha Emelia PKU Muhammadiyah Yogyakarta Hospital, Yogyakarta, Indonesia
  • Rachma Greta Perdana Putri Faculty of Medicine, Universitas Ahmad Dahlan, Yogyakarta, Indonesia

DOI:

https://doi.org/10.12928/admj.v7i1.14565

Keywords:

horizontal chop, numeric rating scale pain, phacoemulsification, ventrical chop

Abstract

Most cataract surgery is done by phacoemulsification method. Phacoemulsification cataract surgery with horizontal chop and vertical chop techniques is quite effective until now. In cataract surgery, generally used topical anesthetic pantocaine 0.5% (tetracaine 0.5%) to control pain in patients. This research aims to compare pain perception using a numeric rating scale in grade 3 cataracts operated by the phaco-horizontal-chop versus vertical-chop technique. This study is a comparative analytical study with a total of 87 subjects, consisting of 45 subjects undergoing surgery with the horizontal-chop technique, and 43 subjects with the vertical-chop technique. All patients were given the same topical anesthetic, pantocaine 0,5%. After the operation done, each subject will be asked about their pain perception using a numerical rating scale parameter. Then, the data were analyzed using univariate and bivariate analysis using chi-square. Among the 87 patients, mean pain scale in this study was 3.51, with a median value of 3.00. The minimum value of the pain scale was 1 while the maximum value was 6. The results showed that there was no significant relationship to pain experienced by patients undergoing phacoemulsification cataract surgery with the horizontal-chop technique compared with the vertical-chop (p = 1,000).

References

Hashemi H, Pakzad R, Yekta A, Aghamirsalim M, Pakbin M, Ramin S, et al. Global and regional prevalence of age-related cataract: a comprehensive systematic review and meta-analysis. Eye. 2020 Aug 1;34(8):1357–70. doi:10.1038/s41433-020-0806-3 PubMed PMID: 32055021.

Lam D, Rao SK, Ratra V, Liu Y, Mitchell P, King J, et al. Cataract. Nat Rev Dis Primers. 2015 Jun 11;1. doi:10.1038/nrdp.2015.14 PubMed PMID: 27188414.

American Academy of Ophtalmology. Basic and Clinical Science Course. Horn EP, Bixler JE, Christopher KL, Cole C, Edgington BD, Islam Y, et al., editors. 2025.

Perone JM, Goetz C, Zaidi M, Lhuillier L. Supracapsular phacoemulsification: Description of the “Garde à vous” technique and comparative clinical results. J Fr Ophtalmol. 2019 Jun 1;42(6):597–602. doi:10.1016/j.jfo.2019.03.002 PubMed PMID: 31097313.

Kaur G, Khurana AK, Chawla U, Dahiya M. A comparative study of divide and conquer, stop and chop and phaco chop techniques of nucleotomy in phacoemulsification. Indian Journal of Clinical and Experimental Ophthalmology. 2021;7(3):471–6. doi:10.18231/j.ijceo.2021.094

Miyamoto N, Kiritoshi S, Akamime R, Akimoto M. Two-hole assisted phaco-chop technique: a more efficient method for safe nucleofractis vertical chopping. Int Ophthalmol. 2021 Sep 1;41(9):3081–6. doi:10.1007/s10792-021-01872-4 PubMed PMID: 33948807.

Guedes J, Pereira SF, Amaral DC, Hespanhol LC, Faneli AC, Oliveira RDC, et al. Phaco-Chop versus Divide-and-Conquer in Patients Who Underwent Cataract Surgery: A Systematic Review and Meta-Analysis. Clinical Ophthalmology. Dove Medical Press Ltd; 2024. p. 1535–46. doi:10.2147/OPTH.S463525

Elboukhani I, Essadouni C, Mchachi A, Benhmidoune L, Chakib A, Rachid R, et al. Topical anesthesia versus peribulbar anesthesia in phacoemulsification cataract surgery and intraocular lens implantation. J Clin Invest Surg. 2020;5(2):100–3. doi:10.25083/2559-5555

Luo JW, Chen YH, Yu JF, Chen YX, Ji M, Guan HJ. Pain perception enhancement in consecutive second-eye phacoemulsification cataract surgeries under topical anesthesia. Int J Ophthalmol. 2024 Aug 18;17(8):1510–8. doi:10.18240/ijo.2024.08.18

Hamid M, Shiwani HA, Hamid F. A survey of anaesthetic preferences in cataract surgery. Int J Ophthalmol. 2022;15(2):342–5. doi:10.18240/ijo.2022.02.22

Liu P, Zhang S, Geng Z, Yuan R, Ye J. Factors affecting pain in patients undergoing bilateral cataract surgery. Int Ophthalmol. 2020 Feb 1;40(2):297–303. doi:10.1007/s10792-019-01178-6 PubMed PMID: 31624986.

Siddiqui Z, Fatima S, Khan AA, Ashraf H, Rizvi SWA. Patient’s pain perception and surgeon satisfaction with topical anaesthsia in phacoemulsification surgery. Indian Journal of Clinical and Experimental Ophthalmology. 2023;9(3):348–53. doi:10.18231/j.ijceo.2023.066

Upadhyay S, Sharma P, Chouhan JK, Goyal R. Comparative evaluation of modified crater (endonucleation) chop and conventional crater chop techniques during phacoemulsification of hard nuclear cataracts: A randomized study. Indian J Ophthalmol. 2022 Mar 1;70(3):794–8. doi:10.4103/ijo.IJO_2172_21 PubMed PMID: 35225516.

Sajjad S, Kounsar H, Rather SR. Phacoemulsification under Topical Anesthesia in a Tertiary Care Hospital. International Journal of Research and Review. 2021 Nov 29;8(11):378–82. doi:10.52403/ijrr.20211148

Wang R, Xu H, Sun H, Zhang S. Small incision phacoemulsification with topical anesthesia during perioperative period: nursing experience and its application. Am J Transl Res. 2021;13(8):9465–71.

Ifantides C, Sieck EG, Christopher KL. Rotary Chop: A New Technique for Teaching Chop and Tackling Mature Cataracts. Ophthalmol Ther. 2020;9:321–7. doi:10.6084/m9.figshare.12034689

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Published

2026-05-11

How to Cite

Imam Masduki, Emelia, D. D. ., & Putri, R. G. P. (2026). COMPARISON OF PAIN PERCEPTION IN CATARACT SURGERY WITH PHACO- HORIZONTAL-CHOP TECHNIQUE VERSUS VERTICAL-CHOP TECHNIQUE IN GRADE 3 CATARACT. Ahmad Dahlan Medical Journal, 7(1), 37–44. https://doi.org/10.12928/admj.v7i1.14565

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