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Comparison of endothelial cell loss following phacoemulsification vs manual small incision cataract surgery: a prospective study

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Session Details

Session Title: Corneal Endothelium & Cataract Surgery

Session Date/Time: Monday 24/09/2018 | 16:30-18:00

Paper Time: 16:54

Venue: Room A3, Podium 1

First Author: : P.Nivean INDIA

Co Author(s): :    N. Madhivanan   A. Kavthekar                 

Abstract Details


To find out changes in endothelial cell density in eyes undergoing Phacoemulsification (Phaco) versus Manual Small Incision Cataract Surgery (M-SICS or SICS) with 6 months post operative follow up.


Observational Prospective study was carried out during a period of 1 year (December 2016 – December 2017)in MN eye hospital ,south India. 200 Eyes of 200 cataract patients were included.


Cataract grading was done by standard LOCS 3 grading system . we included and excluded patients based on our criteria. Specular microscopy was done by taking Three central readings by CEM- 530 specular paracentral microscope and analysed automatically with V1.10.02 software. Central corneal endothelial density (ECD), Co-efficient of variation (CV), Percentage of hexagonality, Central corneal thickness were recorded for all the patients before and after surgery. After examination patients underwent surgery by either phaco or SICS according to patients preference and affordability. Post operatively follow up was done at 1 week, 1 month, 3 month and 6 months.


• There was significant reduction in endothelial cell density(ECD) in M-SICS or SICS compared to phacoemulsification postoperatively at one week, one month, three month and six month follow up when compared with preoperative values (P<0.05). • There was significant reduction in central corneal thickness (CCT) in phaco than SICS at one week postoperative follow up (P = 0.019). • Hexagonal cell % (HEX %) did not change significantly from preoperative values in both the groups (P > 0.05). • Coefficient of variation (CV) was increased at one week postoperatively and then gradually decreased in both the groups.


The corneal endothelium is affected because of various manipulations performed intra-operatively. we conclude that even though SICS causes more EC loss in immediate postoperative period, it gradually stabilizes and in long term follow-up the EC loss is similar for both the techniques. Other morphological and functional indices had no significant difference in both groups at 6 months. In developing countries like India SICS method can be used in centres with large volume overload and financial constraints. To the best of our knowledge there is no study showing this comparison upto 6 months follow up.

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