No difference in endothelial cell loss between standard, MICS phaco

Performing phacoemulsification using either a standard or a microincision technique results in similar corneal endothelial cell losses, according to a study.

Rita Mencucci, MD, and colleagues at the Oto-Neuro-Ophthalmological Surgical Sciences Center, University of Florence, Italy, compared changes to the corneal endothelium induced by phacoemulsification in 80 patients. The researchers randomly assigned 40 patients to surgery involving a standard stop-and-chop phaco technique and 40 patients to stop-and-chop phaco with bimanual microincision cataract surgery.

Patients underwent follow-up evaluations at 1 and 3 months postop, which included central corneal endothelial cell counts, coefficient of cell size variation, hexagonality and pachymetry measurements, according to the study.

The mean preoperative endothelial cell count for both groups combined was 2,245 ± 37 cells/mm². The researchers found that the mean endothelial cell count significantly decreased 102 cells by 1-month follow-up (P < .001) and 144 cells by 3 months (P < .001). However, there was no significant difference in mean endothelial cell counts between groups. There was a mean 25-cell difference in endothelial cell count preoperatively, which decreased to 19 cells at both 1 and 3 months postop.

“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,” the authors said in the study.

Additionally, there was no significant difference in corneal thickness between groups, although it had significantly increased by 10.2 µm for the overall patient sample (P < .001). But mean corneal thickness approached baseline by 3 months follow-up, having only an increase of 3.4 µm (P = .372), according to the study.

The study was published in the August issue of Journal of Cataract and Refractive Surgery.