{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T16:43:39Z","timestamp":1786725819019,"version":"build-2736575974"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>The goal in developing new techniques of cataract surgery is to provide a safer, more efficient surgical experience with the lowest complication rate and endothelial cell loss. We compared the efficiency and safety of stop-and-chop, direct chop, and the novel terminal chop techniques of nuclear fragmentation for cataracts grade II-V.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted a prospective randomized clinical trial comparing three different techniques of phacoemulsification, namely, stop-and-chop, direct chop, and terminal chop to assess any differences between them and to establish whether any one method was superior to the others. The pre- and postoperative parameters studied, included central corneal thickness (CCT), ultrasonic time (UST), endothelial cell density (CD), cell loss and effective phacoemulsification time (EPT), average cumulative dissipative energy (CDE), and best-corrected visual acuity, among others.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      307 eyes were recruited to the study, 102 were recruited to the stop-and-chop group, 103 to the direct chop group, and 102 to the terminal chop group. Statistical differences were found between the techniques with regard to postoperative CCT among NS II (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      . 0001) and NS IV cataracts (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .005) with the lowest values in the terminal chop group among NS II, NS III, and NS IV cataracts. Endothelial cell loss was minimum with a terminal chop in NS II (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .018) and NS IV cataracts (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .245). CDE was minimum in terminal chop across different cataract densities.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Terminal chop showed improvement over the other two techniques in terms of CDE and was comparable to them with regard to other parameters.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijo.ijo_505_23","type":"journal-article","created":{"date-parts":[[2023,11,20]],"date-time":"2023-11-20T00:00:09Z","timestamp":1700438409000},"page":"3658-3662","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["A randomized controlled trial to assess safety and efficacy between terminal chop, stop and chop, and direct chop"],"prefix":"10.4103","volume":"71","author":[{"given":"Aprajita","family":"Sinha","sequence":"first","affiliation":[{"name":"Trauma, Ocular Surface and Refractive Surgery, Department of Ophthalmology, Worcestershire Acute Hospitals NHS Trust, England"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arvind Kumar","family":"Morya","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Resident RP Eye Institute, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinita","family":"Gupta","sequence":"additional","affiliation":[{"name":"Glaucoma, Refractive, Squint, Pediatric Ophthalmology and Medical Retina Services, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ripunjay","family":"Prasad","sequence":"additional","affiliation":[{"name":"Glaucoma Services, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,11,20]]},"reference":[{"key":"R1-20260511","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/S0886-3350(13)80824-3","article-title":"Divide and conquer nucleofractis phacoemulsification: Development and variations","volume":"17","author":"Gimbel","year":"1991","journal-title":"J Cataract Refract Surg"},{"key":"R2-20260511","first-page":"12","article-title":"Phaco-chop technique eliminates central sculpting and allows faster, safer phaco","volume":"10","author":"Nagahara","year":"1993","journal-title":"Ocular Surgery News"},{"key":"R3-20260511","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1016\/S0886-3350(13)80239-8","article-title":"Stop and chop phacoemulsification","volume":"20","author":"Koch","year":"1994","journal-title":"J Cataract Refract Surg"},{"key":"R5-20260511","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/S0039-6257(99)00085-5","article-title":"Phacoemulsification and modern cataract surgery","volume":"44","author":"Linebarger","year":"1999","journal-title":"Surv Ophthalmol"},{"key":"R6-20260511","doi-asserted-by":"crossref","first-page":"1546","DOI":"10.1016\/S0886-3350(02)01323-8","article-title":"Efficacy and safety of the soft-shell technique in cases with a hard lens nucleus","volume":"28","author":"Miyata","year":"2002","journal-title":"J Cataract Refract Surg"},{"key":"R7-20260511","doi-asserted-by":"crossref","first-page":"1463","DOI":"10.1016\/j.jcrs.2013.04.033","article-title":"Comparison of phaco-chop, divide-and-conquer, and stop-and-chop phaco techniques in microincision coaxial cataract surgery","volume":"39","author":"Park","year":"2013","journal-title":"J Cataract Refract Surg"},{"key":"R8-20260511","doi-asserted-by":"crossref","first-page":"14158","DOI":"10.4103\/ijo.IJO_650_17","article-title":"Terminal chop: New technique for full thickness nuclear segmentation in mature hard cataract","volume":"65","author":"Prasad","year":"2017","journal-title":"Indian J Ophthalmol"},{"key":"R10-20260511","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1016\/S0886-3350(00)00702-1","article-title":"Craterand-chop technique for phacoemulsification of hard cataracts","volume":"27","author":"Vanathi","year":"2001","journal-title":"J Cataract Refract Surg"},{"key":"R11-20260511","doi-asserted-by":"crossref","first-page":"1526","DOI":"10.1016\/j.jcrs.2012.07.003","article-title":"Crater-and-split technique for phacoemulsification-Modification of the crater-and-chop technique","volume":"38","author":"Aslan","year":"2012","journal-title":"J Cataract Refract Surg"},{"key":"R12-20260511","doi-asserted-by":"crossref","first-page":"1627","DOI":"10.1016\/j.jcrs.2010.08.003","article-title":"Drill and- crack technique for nuclear disassembly of hard nucleus","volume":"36","author":"Hwang","year":"2010","journal-title":"J Cataract Refract Surg"},{"key":"R13-20260511","doi-asserted-by":"crossref","first-page":"2092","DOI":"10.1016\/j.jcrs.2011.10.002","article-title":"M. Multilevel chop technique","volume":"37","author":"Vasavada","year":"2011","journal-title":"J Cataract Refract Surg"},{"key":"R14-20260511","doi-asserted-by":"crossref","first-page":"1799","DOI":"10.1016\/j.jcrs.2011.04.024","article-title":"Microincision versus small-incision coaxial cataract surgery using different power modes for hard nuclear cataract","volume":"37","author":"Kim","year":"2011","journal-title":"J Cataract Refract Surg"},{"key":"R15-20260511","doi-asserted-by":"crossref","first-page":"236","DOI":"10.3928\/15428877-20100303-13","article-title":"Ultrasound energy in phacoemulsification: A comparative analysis of phaco-chop and stop-and-chop techniques according to the degree of nuclear density","volume":"41","author":"Park","year":"2010","journal-title":"Ophthalmic Surg Lasers Imaging"},{"key":"R16-20260511","doi-asserted-by":"crossref","first-page":"e378","DOI":"10.1111\/aos.14582","article-title":"Comparison of the phaco chop and drill-and-crack techniques for phacoemulsification of hard cataracts: A fellow eye study","volume":"99","author":"Abdelmotaal","year":"2021","journal-title":"Acta Ophthalmol"},{"key":"R17-20260511","doi-asserted-by":"crossref","first-page":"1454","DOI":"10.3109\/02713683.2015.1127394","article-title":"Stop-chop versus retro-chop nucleotomy during phacoemulsification","volume":"41","author":"Hwang","year":"2016","journal-title":"Curr Eye Res"},{"key":"R18-20260511","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1016\/S0886-3350(96)80200-8","article-title":"Effects of phacoemulsification time on the corneal endothelium using phacofracture and phaco chop techniques","volume":"22","author":"Pirazzoli","year":"1996","journal-title":"J Cataract Refract Surg"},{"key":"R19-20260511","doi-asserted-by":"crossref","first-page":"1464","DOI":"10.1016\/S0886-3350(98)80167-3","article-title":"Evaluation of in situ fracture versus phaco chop techniques","volume":"24","author":"Ram","year":"1998","journal-title":"J Cataract Refract Surg"},{"key":"R20-20260511","doi-asserted-by":"crossref","first-page":"217","DOI":"10.4103\/ijo.IJO_711_18","article-title":"Retrospective study on outcomes of terminal chop technique of nuclear fragmentation in phacoemulsification and combined surgery: An observational study","volume":"67","author":"Morya","year":"2019","journal-title":"Indian J Ophthalmol"},{"key":"R21-20260511","doi-asserted-by":"crossref","first-page":"1638","DOI":"10.1016\/S0886-3350(00)00544-7","article-title":"Phaco-chop versus stop-and-chop nucleotomy for phacoemulsification","volume":"26","author":"Vajpayee","year":"2000","journal-title":"J Cataract Refract Surg"}],"container-title":["Indian Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/IJO.IJO_505_23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T16:26:07Z","timestamp":1786724767000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/IJO.IJO_505_23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,20]]},"references-count":19,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.4103\/ijo.ijo_505_23","relation":{},"ISSN":["0301-4738","1998-3689"],"issn-type":[{"value":"0301-4738","type":"print"},{"value":"1998-3689","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,20]]},"assertion":[{"value":"2023-02-18","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-27","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}