Endothelial cell density and corneal pachometry after no-stitch, small-incision cataract surgery

In a prospective study we used the change of central and peripheral (12 o'clock-position) corneal thickness (CT) after no-stitch small incision cataract surgery as a parameter of tissue traumatisation (33 eyes) and compared the values to a series of cases (32 eyes) with conventional 3.5 mm scleral step incision. In both groups the peripheral measurements showed a higher increase in corneal thickness than the central. After 1 month all eyes regained their central preoperative thickness. Increase in corneal thickness (delta CTc, delta CTp) after the different postoperative periods were correlated. The values of the central cornea showed no significant difference between the two groups. 1, 7 and 30 days after surgery the increase of peripheral CT was significantly higher in the no-stitch group. This fact was underlined by the clinical aspect at the slit lamp and is due to the anatomical and surgical characteristic of this procedure. One month postoperatively there was no increased endothelial cell loss in the no-stitch group (3%). No-stitch cataract surgery surgery provides a lot of intra- and postoperative advantages. The problem of increased swelling of the peripheral corneal entry seems to be a secondary one as corneal thickness decreases with time. Concerning the prospective endothelial cell loss it is mandatory to study the long term results.