Comparison of endothelial cell loss and surgically induced astigmatism following conventional extracapsular cataract surgery, manual small-incision surgery and phacoemulsification.
OBJECTIVE
To compare the surgically induced astigmatism (SIA) and endothelial cell loss following conventional extracapsular cataract surgery (ECCE), manual small-incision cataract surgery (Blumenthal technique)(SICS) and phacoemulsification (PE) with non-foldable intraocular lens implantation.


METHODS
186 cataractous eyes with nuclear sclerosis grade 3 or less were randomized to undergo ECCE, SICS or PE with intraocular lens (non-foldable) implantation after a detailed pre-operative assessment. Keratometry and specular microscopy were performed pre-operatively and 6 weeks postoperatively. Surgically induced astigmatism was calculated using the rectangular coordinate method (Holladay et al.).


RESULTS
Mean endothelial cell loss was similar for all three groups (p = 0.855); ECCE induced a loss of 4.72% (SD: 13.07); SICS 4.21% (SD: 10.29) and PE 5.41% (SD: 10.99). Mean SIA was 1.77D (1.61D) for the ECCE group, 1.17D (0.95D) for the SICS group and 0.77D (0.65D) for the PE group (p = 0.001). The magnitude of the difference between the SICS and the PE group was 0.4D.


CONCLUSIONS
PE induced less astigmatism than SICS and ECCE in this study but the magnitude of the difference between SICS and PE was small. There was no significant difference in endothelial cell loss between the three groups.
George
Ronnie
R
Jaslok Community Ophthalmology Center, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India. drgeorges@eth.net
Rupauliha
Pankaj
P
Sripriya
A V
AV
Rajesh
P S
PS
Vahan
P Vishnu
PV
Praveen
Smita
S
D001251:Astigmatism / Q000209:etiology*; D002387:Cataract Extraction; D002452:Cell Count; D004728:Endothelium, Corneal / Q000473:pathology*; D005260:Female; D006801:Humans; D015994:Incidence; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D018918:Phacoemulsification; D011183:Postoperative Complications