Evaluation Of Endothelial Cell Density After Phacoemulsification In Various Grades Of Cataract Consuming Varied Volumes Of Balanced Salt Solution

To estimate the endothelial cell density and endothelial cell loss percentage after Phacoemulsification, in which the volume of BSS used for the procedure was divided into three sub groups. A total of 1168 eyes were included in the study from July to December 2025. 

The study was conducted at Radha Raman Hospital, Odisha, India. All surgeries was performed by the presenting author using the same Phacoemulsification machine ( Centurion Vision System, Alcon Laboratories, Fort Knox ). The Fluidics settings were kept constant in all procedures included in the study(IOP-20,AFR-23, vaccuum-450 in panel mode, Irrigation Factor-1.6, Vaccuum rise-0, IOP ramp-fast). The Phaco power settings  Torsional energy 40-60 threhold 20 for both Chop and Quadrant removal steps.

This was a prospective randomized study. In the pateints included in the study,the total volume of fluid aspirated during Phacoemulsification procedure was recorded and based on that they were subdivided into three groups ; - Group 1 (30-35CC) , Group 2 (35-40CC) , Group 3 (40-45CC). The Endothelial cell density and the percentage of Endothelial cell loss were compared between the three groups at the end of 15 days, 1 month and 3 months post operative. Each subgroup of patients required varying amount of energy based on the grade of nucleus sclerosis and the corleation of the endothelial cell loss for a fixed volume of fluid aspirated but bearing different CDE values were also analysed.

Percentage of endothelial cell loss was low for low volumes of total fluid aspirated during the procedure. The least cell loss was found in Group 1 (30-35 CC) on the 15th post operative day, and little change was observed in the cell density on subsequent follow ups at 1 month and 3 months. Both the other groups showed more cell loss on the firts visit which was statistically significant. Group 3 (40-45CC) showed the cell loss to continue at 1 month. No group showed significant Endothelial cell loss between 1month and 3 months follow up visits. Patients in whom the CDE count was higher showed higher percentage of cell loss and it corelated well with the fluid aspirated in all three groups.  

Low volumes of total fluid aspirated during Phacoemulsification leads to low percentage of endothelial cell loss. Surgery under physiological IOP and low fluidics lead to low volumes of fluid consumed during the procedure and therefore are very friendly towards Corneal Endothelial cells.