Corneal endothelial cell loss following phacoemulsification using the Small-Port Phaco

Area of Science:

• Ophthalmology
• Surgical Technology
• Corneal Science

Background:

• Phacoemulsification is a common cataract surgery technique.
• Corneal endothelial injury is a potential complication.
• New instruments aim to minimize surgical trauma.

Purpose of the Study:

• To evaluate corneal endothelial cell loss after cataract surgery using the Small-Port Phaco (SPP) instrument.
• To compare the SPP with a standard phacoemulsification instrument regarding endothelial injury.
• To identify operative factors influencing endothelial damage.

Main Methods:

• A comparative study of 72 eyes undergoing phacoemulsification.
• Group 1 (33 eyes) used the SPP instrument; Group 2 (39 eyes) used a standard instrument.
• Endothelial cell density was measured by specular microscopy preoperatively and at 1 and 3 months post-surgery.

Main Results:

• Significantly less endothelial cell loss was observed in the SPP group at 1 and 3 months (P < .05).
• SPP group showed 4.3% loss at 1 month and 5.6% at 3 months.
• Standard group showed 6.9% loss at 1 month and 8.3% at 3 months.
• Shorter ultrasound emission duration and lower ultrasound power were used with SPP.
• Reduced corneal endothelial damage correlated with lower total ultrasound energy expended.

Conclusions:

• The Small-Port Phaco instrument results in less corneal endothelial injury compared to standard phacoemulsification.
• Reduced ultrasound energy expenditure is the likely mechanism for decreased endothelial cell loss.
• SPP offers a potentially safer option for cataract surgery, preserving corneal health.