Corneal endothelial damage after cataract surgery: Microincision versus standard technique.
OBJECTIVE
To compare corneal endothelial changes after phacoemulsification performed with a standard technique versus a bimanual microincision cataract surgery (MICS) technique.


METHODS
University ophthalmology department.


METHODS
Eighty patients scheduled for routine cataract surgery were randomized into 2 groups; 40 eyes had standard stop-and-chop phacoemulsification (standard group) and 40 eyes had stop-and-chop phacoemulsification with microincision surgery (MICS group). Central corneal endothelial cell counts, coefficient of variation in cell size, hexagonality, and pachymetry were assessed preoperatively and 1 and 3 months postoperatively.


RESULTS
The mean preoperative cell count in the entire sample was 2245 cells/mm2 +/- 37 (SE). The mean decreased by 102 cells at 1 month (95% confidence interval [CI], -133 to -71; P < .001) and by 144 cells at 3 months (95% CI, -187 to -102; P < .001). The difference between the standard group and the MICS group was 25 cells at baseline (95% CI, -169 to 120 cells; P = .739), 19 cells at 1 month (95% CI, -163 to 126; P = .799), and 19 cells at 3 months (95% CI, -164 to 125; P = .793). 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. Corneal thickness increased by 10.2 microm in the overall sample (95% CI, +4.5 to +16.0; P < .001) and approached baseline values by 3 months with an increase of 3.4 microm (95% CI, -4.1 to 10.8; P = .372). There was no difference in corneal thickness between the groups.


CONCLUSIONS
No significant differences in corneal endothelial cell loss or endothelial morphology were found between MICS and standard incision techniques.
Mencucci
Rita
R
Department of Oto-Neuro-Ophthalmological Surgical Sciences Eye Clinic, University of Florence, Florence, Italy. rita.mencucci@unifi.it
Ponchietti
Claudia
C
Virgili
Gianni
G
Giansanti
Fabrizio
F
Menchini
Ugo
U
D000368:Aged; D002452:Cell Count; D048429:Cell Size; D003316:Corneal Diseases / Q000175:diagnosis / Q000209:etiology*; D004728:Endothelium, Corneal / Q000473:pathology*; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects* / Q000379:methods; D011446:Prospective Studies