Abstract
The objective of this retrospective cohort study is to compare the Pacman cutting technique with the trisection cutting technique for hydrophobic acrylic intraocular lens extraction. A total of 29 eyes of 29 patients requiring IOL removal were selected and enrolled in this study. The patients in group 1 (13 cases) underwent the conventional trisection cut technique from May 2022 to Dec. 2022. The patients in group 2 (16 cases) underwent the modified partial IOL cutting technique (Pacman cutting technique) from Jan. 2023 to June 2023. Corneal endothelial cells (CECs) count, slit-lamp examination, and intraocular pressure (IOP) measurement were conducted at all preoperative and postoperative visits. Surgical time, intraoperative and postoperative complications were recorded. The mean surgical time was 3.48 ± 1.54 minutes (range: 2 to 7 minutes) for the trisection cut technique group and 2.52 ± 1.18 minutes (range: 2 to 5 minutes) for the Pacman cut technique group. There was a statistically significant difference between the two groups in terms of surgical duration (P < .05). There was no difference in the mean preoperative CEC counts (group 1: 1924 ± 462, group 2: 1876 ± 516, P > 0.05). However, three months after the operation, the count of CECs decreased by 213 ± 72 (11%) in group 1 and 142 ± 57 (8%) in group 2. The decrease in CECs in group 1 was greater than that in group 2, and the difference was statistically significant (P < .05). There were no serious complications affecting vision in either group during the follow-up period. This study showed that the Pacman cutting technique is more effective and safer than the trisection cutting technique for hydrophobic acrylic IOL removal.