Comparison Of Novel Contact Lens-Shell Vs Soft-Shell Technique For Corneal Endothelial Protection In High-Risk Cataract Phacoemulsification.

To compare the efficacy of the contact lens-shell technique(CST) vs the soft-shell technique(SST) in minimizing endothelial cell loss(ECL) during phacoemulsification in high-risk cataracts.

 The Prospective randomised comparative study was conducted by a Single Surgeon at our hospital
in India, between Jan and July 25.

A prospective randomized study was conducted on 40 eyes with high-risk cataracts (small pupil, mature and hard cataract) that underwent phacoemulsification using either CST or soft shell technique (SST) with 20 eyes in each group. The CST used soft-bandage contact lens (Etaficon A hydrogel) as a mechanical protector, while the SST used viscoelastic agents, HPMC 2.4% and sodium hyaluronate 1.4% during surgery to protect corneal endothelium. Outcomes were assessed at 1, 7, and 30 post-op days (PODs), measuring visual acuity (UCVA & BCVA), intraocular pressure (IOP), and central corneal thickness (CCT), whereas corneal endothelial cell count (ECC) was measured at 7 and 30 PODs.

No significant differences were observed in UCVA, BCVA, or CCT (P>0.05). At 1day post-op, IOP was significantly lower in CST (13.2±2.92 mmHg) versus SST (16.96±6.32 mmHg, P=0.02). By 30 days, CST demonstrated significantly reduced ECL (3.02%±5.31%) compared to SST (8.81%±12.78%, P=0.03).

The Contact Lens Shell Technique reduced the endothelial cell loss and protected the corneal endothelium during phacoemulsification in high-risk cases.