Corneal endothelial damage after cataract surgery: Microincision versus standard technique

J Cataract Refract Surg. 2006 Aug;32(8):1351-4. doi: 10.1016/j.jcrs.2006.02.070.

Abstract

Purpose: To compare corneal endothelial changes after phacoemulsification performed with a standard technique versus a bimanual microincision cataract surgery (MICS) technique.

Setting: University ophthalmology department.

Methods: Eighty patients scheduled for routine cataract surgery were randomized into 2 groups; 40 eyes had standard stop-and-chop phacoemulsification (standard group) and 40 eyes had stop-and-chop phacoemulsification with microincision surgery (MICS group). Central corneal endothelial cell counts, coefficient of variation in cell size, hexagonality, and pachymetry were assessed preoperatively and 1 and 3 months postoperatively.

Results: The mean preoperative cell count in the entire sample was 2245 cells/mm2 +/- 37 (SE). The mean decreased by 102 cells at 1 month (95% confidence interval [CI], -133 to -71; P < .001) and by 144 cells at 3 months (95% CI, -187 to -102; P < .001). The difference between the standard group and the MICS group was 25 cells at baseline (95% CI, -169 to 120 cells; P = .739), 19 cells at 1 month (95% CI, -163 to 126; P = .799), and 19 cells at 3 months (95% CI, -164 to 125; P = .793). There were no changes in the coefficient of variation or morphology in the overall sample, and the pattern of change did not differ between the 2 groups. Corneal thickness increased by 10.2 microm in the overall sample (95% CI, +4.5 to +16.0; P < .001) and approached baseline values by 3 months with an increase of 3.4 microm (95% CI, -4.1 to 10.8; P = .372). There was no difference in corneal thickness between the groups.

Conclusion: No significant differences in corneal endothelial cell loss or endothelial morphology were found between MICS and standard incision techniques.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Cell Count
  • Cell Size
  • Corneal Diseases / diagnosis
  • Corneal Diseases / etiology*
  • Endothelium, Corneal / pathology*
  • Female
  • Humans
  • Lens Implantation, Intraocular
  • Male
  • Middle Aged
  • Phacoemulsification / adverse effects*
  • Phacoemulsification / methods
  • Prospective Studies