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

The comparative analysis of the corneal endothelium modifications (density, pleiomorphism and poly-megetism) appeared as a result of the phacoemulsification through divide and conquer (D-C) respectively phaco-chop (P-C) technique.

One year prospective, observational and interventional clinical study on 60 eyes with cataract surgery through phacoemulsification by the same surgeon. They were split in 2 groups of study according to the hardness of the cataract (Group A-30 eyes with the hardness of the cataract 3+ and Group B-30 eyes with the hardness of the cataract 4+). In both groups half of the patients were treated with P-C technique surgery and the other half with D-C technique surgery. The groups were homogeneous in relation to age, cataract density, and without associated systemic and ocular pathology.

In all cases the endothelial analysis was performed using the endothelial direct microscope and the ultrasonic pachymetry in presurgery, in the second postoperative day, at 14 days and 2 months. At the end of the study in Group A (3+) there were not noticed any significant modifications in loss of the endothelial cells through both technique surgery. In Group B (4 =) appeared significant modifications with much more losses in (D-C) technique surgeries. Ultrasonic pachymetry in the second day of postsurgery has shown temporary increase of corneal thickness compared to presurgery due to corneal edema, with recovery two months post surgery.

Regardless of the technique, phacoemulsification leads to endothelial modifications. In our study the P-C technique maintained a better endothelial structure homeostasis.