Comparison of endothelial cell loss after cataract surgery: Phacoemulsification versus manual small-incision cataract surgery: Six-week results of a randomized control trial
Received 2 February 2009; received in revised form 11 August 2009; accepted 3 September 2009.
Purpose
To compare endothelial cell loss in cataract surgery by phacoemulsification and by manual small-incision cataract surgery (SICS).
Settings
Tertiary care ophthalmic center, India.
Methods
A complete ophthalmologic examination and endothelial specular microscopy were performed preoperatively and 1 and 6 weeks postoperatively in patients having cataract surgery. The endothelial cell count (ECC) was calculated manually and automatically using an LSM 12000 specular microscope. Patients were randomly allocated to have SICS or phacoemulsification using a random number table. Phacoemulsification was performed using the stop-and-chop technique and SICS, by viscoexpression.
Results
The study evaluated 200 patients, 100 in each group. The mean preoperative ECC by the manual counting method was 2950.7 cells/mm2 in the phacoemulsification group and 2852.5 cells/mm2 in the SICS group and by the automated counting method, 3053.7 cells/mm2 and 2975.3 cells/mm2, respectively. The difference at 6 weeks was 543.4 cells/mm2 and 505.9 cells/mm2, respectively, by the manual method (P = .44) and 474.2 cells/mm2 and 456.1 cells/mm2, respectively, by the automated method (P = .98). The corrected distance visual acuity at 6 weeks was better than 6/18 in 98.5% of eyes in the phacoemulsification group and 97.3% of eyes in the SICS group.
Conclusion
There were no clinically or statistically significant differences in ECC loss or visual acuity between phacoemulsification and SICS, although there was a small difference in the astigmatic shift.
Financial Disclosure
No author has a financial or proprietary interest in any material or method mentioned.
From H.V. Desai Eye Hospital, Pune, India
Corresponding author: Parikshit Gogate, H.V. Desai Eye Hospital, 73/2 Tarawade Wasti, Mohammadwadi, Hadapsar, Pune 411028, India.
S. Krishnaiah, International Centre for Advancement of Rural Eye Care, L.V. Prasad Eye Institute, Hyderabad, India, randomized the schedule. Swapna Deshpande provided biostatistical assistance. Kuldeep Dole, MSc, MS(Ophth), reviewed the manuscript.
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