Half-moon supracapsular nucleofractis phacoemulsification: safety, efficacy, and functionality.

Purpose: To compare the safety, efficacy, and functionality of half-moon supracapsular phacoemulsification, a variation of the nucleofractis technique, with those of the stop-and-chop technique.

Setting: Atatürk Training and Research Hospital, 2nd Ophthalmology Department, Ankara, Turkey.

Methods: This prospective randomized study comprised 100 eyes having phacoemulsification with the half-moon supracapsular (Group 1, 50 eyes) or stop-and-chop (Group 2, 50 eyes) technique. The half-moon supracapsular technique is based on hydrodissection-assisted partial prolapse of the nucleus. After the prolapsed nucleus is chopped horizontally and the first wedge removed, quadrant removal is performed endocapsularly. Follow-up examinations were at 1, 7, 30, and 90 days.

Results: The 2 groups were similar in demographic features and surgical difficulty factors. There was no difference in the complication rate. The phaco time (mean: Group 1, 0.2 minutes +/- 0.1 (SD); Group 2, 0.4 +/- 0.4 minutes), average power (mean 11.3% +/- 6.9% and 18.3% +/- 7.3%, respectively), effective phaco time (1.7 +/- 1.8 seconds and 4.8 +/- 6.5 seconds, respectively), and total operation time (12.3 +/- 3.2 minutes and 14.3 +/- 4.3 minutes, respectively) were significantly lower in Group 1 than in Group 2. One day postoperatively, the increase in central corneal thickness increase was significantly greater in Group 1 (P = 0.011), with no significant differences thereafter. The visual acuity increase and contrast sensitivity scores at 90 days were similar in the groups.

Conclusions: The half moon supracapsular technique shortened the phacoemulsification procedure and lowered phaco energy, indicating it protects surrounding intraocular tissue. There was no difference between techniques in reliability and functionality.