[Comparative study of endothelial changes in cataract surgery with phacoemulsification technique]

Area of Science:

• Ophthalmology
• Surgical Techniques
• Corneal Health

Background:

• Cataract surgery involves phacoemulsification, a technique that can affect the corneal endothelium.
• Understanding the impact of different phacoemulsification methods on endothelial cells is crucial for patient outcomes.

Purpose of the Study:

• To comparatively analyze corneal endothelium modifications after phacoemulsification using divide and conquer (D-C) versus phaco-chop (P-C) techniques.
• To assess the impact of cataract density on endothelial cell loss with each surgical method.

Main Methods:

• A one-year prospective clinical study involving 60 eyes undergoing phacoemulsification by a single surgeon.
• Patients were divided into two groups based on cataract hardness (3+ and 4+), with each group receiving either P-C or D-C technique.
• Corneal endothelium analysis (density, pleomorphism, poly-megetism) and ultrasonic pachymetry were performed pre- and post-surgery at various intervals.

Main Results:

• No significant endothelial cell loss was observed in Group A (3+ cataract hardness) with either technique.
• Group B (4+ cataract hardness) showed significant endothelial cell loss, with greater losses noted after the D-C technique.
• Postoperative corneal edema was transient, with corneal thickness returning to baseline by two months.

Conclusions:

• Phacoemulsification, irrespective of technique, induces changes in the corneal endothelium.
• The phaco-chop (P-C) technique demonstrates superior maintenance of endothelial structure homeostasis compared to the divide and conquer (D-C) technique, particularly in denser cataracts.