Comparison of changes in endothelial cell count and central corneal thickness after phacoemulsification and small-incision cataract surgery: A prospective observational study at a tertiary care center of eastern Uttar Pradesh
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Date
2022-11
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All India Ophthalmological Society
Abstract
Purpose: Morphological stability and functional integrity of corneal endothelium are necessary to maintain long-term corneal transparency. When the number of endothelial cells drops below 450�0 cells/mm2, corneal edema, irreversible loss of corneal transparency, and decreased vision occur. There is concern regarding manual small-incision cataract surgery (MSICS) being more harmful to the endothelium in comparison to phacoemulsification. Our study aims to determine which technique maintains the corneal parameters closest to the normal physiological state. Methods: A prospective observational study was conducted over a period of 15 months on 100 eyes, out of which 43 patients underwent phacoemulsification surgery and 57 underwent MSICS. TOPCON SP-1P, Version 1.41, 50� Hz frequency, noncontact specular microscope with pachymeter was used to measure endothelial cell count (ECC) and central corneal thickness (CCT) on four occasions: 1 day prior to surgery and on day 1, 3rd week, and 6th week after surgery. Results: In total, 100 eyes of 100 subjects were studied with no dropout during the study period. The age range was 40� years. There was no statistically significant difference between the preoperative mean ECC and mean CCT in phacoemulsification and SICS groups. A statistically significant difference was observed in the postoperative mean ECC (P < 0.01) and mean CCT (P < 0.001) on day 1 and 3rd week between the phacoemulsification and SICS groups, respectively. The mean endothelial cell loss at 6 weeks was less with SICS but comparable with phacoemulsification. Conclusion: SICS is significantly faster, less expensive, less technology dependent, can deal with all types of cataracts, is relatively safe, and is more appropriate for advanced cataracts.
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Keywords
CCT, ECC, phacoemulsification, SICS, specular microscopy
Citation
Kumar Ram, Wahi Dipti, Tripathi Punita. Comparison of changes in endothelial cell count and central corneal thickness after phacoemulsification and small-incision cataract surgery: A prospective observational study at a tertiary care center of eastern Uttar Pradesh. Indian Journal of Ophthalmology. 2022 Nov; 70(11): 3954-3959