Tilt and tumble technique shortens surgical time compared with divide and conquer in cataract surgery trial
Key Takeaways
- Tilt and tumble reduced surgical time, including shorter overall operation, phacoemulsification, and ultrasound times compared with divide and conquer.
- Safety and postoperative outcomes were similar between the two techniques, with no significant differences in energy use, complications, or follow-up measures.
In a randomized trial, the tilt and tumble technique resulted in shorter surgical and phaco times than divide and conquer, while showing similar safety, energy use, and postoperative outcomes.
The study included 535 patients undergoing cataract surgery who were randomly assigned to one of the two techniques.
The tilt and tumble technique showed shorter surgical times across multiple measures. Mean operation time was 4.68 minutes with tilt and tumble compared with 6.50 minutes with divide and conquer (P < 0.001). Phacoemulsification time was 60 seconds versus 148 seconds (P < 0.001), and ultrasound time was 32 seconds versus 40 seconds (P < 0.001), respectively.
Baseline characteristics were similar between groups. Energy expenditure measured by cumulative dissipated energy, intraoperative complication rates, and postoperative outcomes did not differ significantly between the techniques.
Reference
Ursberg J, Viberg A, Zetterberg M. Comparative Clinical Outcomes of Divide and Conquer and Tilt and Tumble Cataract Surgery: A Randomized Controlled Trial. Clin Ophthalmol. 2026;20:579389. doi: 10.2147/OPTH.S579389. PMID: 41809207; PMCID: PMC12968821.
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