title: Randomized, double-masked clinical trial evaluating corneal endothelial cell loss after cataract extraction and intraocular lens implantation: Fluid-based system versus ultrasound phacoemulsification.
abstract: OBJECTIVE
  To assess the endothelial cell loss after cataract extraction using a fluid-based system and compare it with conventional ultrasound.
  
  
  METHODS
  A total of 46 eyes of 23 patients with up to 3+ bilateral cataract were included. The first eye was randomized to either fluid-based system or conventional ultrasound, and the fellow eye received the alternate system. Visual acuity and ultrasound pachymetry were measured preoperatively and at 1 day, 1 week, and 1 and 3 months postoperatively. Specular microscopy was performed preoperatively and 3 months after the surgery. Data was analyzed using the paired t test and Wilcoxon signed rank test. A P value less than 0.05 was considered statistically significant.
  
  
  RESULTS
  Postoperatively, no significant differences were found among the groups. However, there was a significant difference (P < 0.01, analysis of variance with Tukey as posttest) in corneal pachymetry at day 1 after the surgery compared with baseline in both groups. There was a 6.3% and 7.9% loss of endothelial cells in the fluid-based system and ultrasound group, respectively.
  
  
  CONCLUSIONS
  Visual acuity, pachymetry, and endothelial cell loss after cataract extraction and intraocular lens implantation using a fluid-based system is similar to conventional ultrasound.
authors.affiliation: Magill Research Center for Vision Correction, Storm Eye Institute, Medical University of South Carolina, Charleston, SC 29425, USA. sandoval@musc.edu
authors.forename: Helga P
authors.initials: HP
authors.lastname: Sandoval
authors.forename: Luis E Fernández
authors.initials: LE
authors.lastname: de Castro
authors.forename: David T
authors.initials: DT
authors.lastname: Vroman
authors.forename: Kerry D
authors.initials: KD
authors.lastname: Solomon
mesh_terms: D002452:Cell Count; D003315:Cornea / Q000000981:diagnostic imaging; D004311:Double-Blind Method; D004728:Endothelium, Corneal / Q000473:pathology*; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000379:methods*; D011446:Prospective Studies; D014463:Ultrasonography; D014792:Visual Acuity