Corneal endothelial cell loss after phacoemulsification versus extracapsular cataract extraction in management of senile cataract

Purpose
To compare the corneal endothelial cell density and morphology in early postoperative period after phacoemulsification and extracapsular cataract extraction (ECCE) in management of senile cataract.
Design
This is a prospective, nonrandomized clinical interventional case study.
Setting
The study was conducted at the Department of Ophthalmology, Assiut University, Egypt.
Patients and methods
This study included 70 eyes of 70 patients with uneventful senile cataract that were divided into two groups. Group I included 35 eyes with nuclear hardness up to grade IV (LOCS III) and underwent standard phacoemulsification. Group II included 35 eyes with nuclear hardness of grades V and VI and underwent conventional ECCE. In all cases, specular microscopy (NIDEK CEM 530) was done preoperatively and 1 month postoperatively.
Results
The preoperative mean ± SD endothelial cell count in group I was 2372 ± 379, whereas in group II was 2313 ± 335. In each group, there was a statistically significant decline in endothelial cell density after 1 month. The mean ± SD endothelial cell count 1 month postoperatively in group I was 2106 ± 344, whereas in group II was 2030 ± 295. There was no statistically significant difference in overall percentage of endothelial cell loss between the two groups. The coefficient of variation and endothelial cell hexagonality were significantly changed 1 month postoperatively in each group with no significant difference between them.
Conclusion
The adverse effect of phacoemulsification on the corneal endothelial cells when it is performed for senile cataract with nuclear hardness up to grade IV is nearly similar to that caused by ECCE when it is done for cataract with nuclear hardness of grades V and VI.