CORNEAL ENDOTHELIAL CHANGES IN EYES UNDERGOING PHACOEMULSIFICATION VERSUS MANUAL SMALL INCISION CATARACT SURGERY
Keywords:
Corneal endothelial cell loss, Phacoemulsification, Manual small incision cataract surgery, Specular microscopyAbstract
Objective: To compare the changes in central corneal endothelial integrity in eyes undergoing phacoemulsification and manual small incision cataract surgery (MSICS) before and after cataract surgery and between the two surgical procedures.
Material and Methods: A randomized controlled trial was performed in the department of Ophthalmology, Hayatabad Medical Complex, Peshawar, Pakistan from July 2015 to December 2015. Patients meeting the inclusion criteria of both genders were admitted from outpatient department after complete ophthalmological examination. Central corneal endothelial cell density (ECD) was measured pre operatively by using specular microscope. Total 160 patients were randomly assigned into two groups, each group having equal number of patients (80). Group 1 patients underwent phacoemulsification, whereas MSICS was performed in group 2 patients. Postoperatively, specular microscopy was performed to measure final central corneal ECD at 6th weeks of surgery on the last follow up. The final outcome readings
were measured and data was entered in proforma.
Results: In phacoemulsification group mean age was 61 years ± 1.27 SD where as in MSICS mean age was 61 years ± 1.31. SD with in phacoemulsification group 53% patients were male and 47% patients were female whereas in MSICS group 55% were male and 45% patients were female. Preoperatively mean endothelial cell density in phacoemulsification
group was 2852cells/mm2with standard deviation ± 2.13 whereas in MSICS group mean endothelial cell density was 2950 cells/mm2 with standard deviation ± 2.26. Mean endothelial cell density postoperatively after 6 weeks in phacoemulsification group was 2348 cells/mm2 with standard deviation ± 2.88 whereas in MSICS group mean endothelial cell density was 2408 cells/mm2 with standard deviation ± 2.73.Mean endothelial cell loss was analyzed among two groups after 6 weeks postoperatively, 504 cells/mm2 (17.2%) endothelial cell loss was recorded in phacoemulsification group while 542 cells/mm2 (18.4%) endothelial cell loss was recorded in MSICS group.
Conclusion: The mean corneal endothelial cell loss was slightly less in phacoemulsification as compared to MSICS.
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