COMPARISON OF ENDOTHELIAL CELL LOSS AFTER PHACOEMULSIFICATION AND MANUAL SMALL INCISION CATARACT SURGERY

BACKGROUND Endothelial cell loss during cataract surgery leads to corneal decompensation and visual loss. OBJECTIVES To compare endothelial cell loss after cataract surgery, phacoemulsification versus manual Small-Incision Cataract Surgery (SICS), by specular microscope as MSICS is still the most common type of cataract surgery done in our country. STUDY DESIGN Prospective interventional randomised comparative study in SDEH, Osmania Medical College, Hyderabad between Jan. 2013 and Aug. 2014. MATERIAL AND METHODS 100 patients of age > 40 years with senile cataract of NS Gr II and NS Gr III and divided into 2 groups of 50 each. A complete ophthalmologic examination and endothelial cell count by specular microscopy were performed preoperatively and 1 and 6 weeks postoperatively in all patients undergoing cataract surgery. Patients were randomly allocated to undergo SICS or phacoemulsification by same surgeon. RESULTS The study evaluated 100 patients, 50 in each group. The mean preoperative endothelial cell density was 2575 cells/mm2 in the phacoemulsification group and 2535 cells/mm(2) in the SICS group (P -0.8397). The difference at 6 weeks was 169.90 cells/mm2 and 202.80 cells/mm(2) in phacoemulsification group and SICS group respectively (P = 0.5928). CONCLUSION There was no clinically or statistically significant difference in endothelial cell loss between phaco and SICS in the hands of an experienced surgeon.