Comparison Of Pre And Postoperative Specular Microscopy In Manual Small Incision Cataract Surgery (M-Sics) With Nucleus Extraction Techniques: Irrigating Vectis Vs. Viscoexpression

To compare pre and postoperative specular microscopy values in patients undergoing manual small incision cataract surgery (M-SICS) with two different nucleus extraction techniques—irrigating vectis and viscoexpression. The analysis focuses on assessing statistical significance differences in cell densities, coefficient of variation, hexagonality, and mean cell area.

Sala Uno Ophthalmology Clinic, Cataract and Refractive Surgery Department, Mexico City, Mexico.

This prospective, longitudinal, and comparative study included 215 eyes, divided into two groups based on the extraction surgical technique: irrigating vectis and viscoexpression, with 109 and 106 patients, respectively. Specular microscopy was conducted in the month before surgery by an experienced surgeon who determined the nucleus extraction technique. Specular microscopy was performed at the 1st and 3rd postoperative months, and the results were compared with the preoperative assessment.

Specular microscopy changes of Cell Density Loss in the viscoexpression group showed lower mean values compared to irrigating vectis. Minimal changes in the coefficient of variation were observed across both groups. Hexagonality Loss: Patients with irrigating vectis experienced greater hexagonality loss compared to those with viscoexpression. The three-Month Follow-up revealed consistent patterns in both groups.

This study aimed to compare endothelial changes between viscoexpression and irrigating vectis in patients undergoing M-SICS. The results suggest fewer cell density losses and hexagonality changes with viscoexpression. We propose that an experienced surgeon using viscoexpression may result in reduced endothelial cell changes and a smaller impact on cell area.