Comparison of corneal endothelial cell loss during phacoemulsification using continuous anterior chamber infusion versus those using ophthalmic viscosurgical device: randomized controlled trial.
OBJECTIVE
We conducted this study to evaluate and compare corneal endothelial cell loss between phacoemulsification with continuous anterior chamber infusion using anterior chamber maintainer (ACM) and phacoemulsification using ophthalmic viscosurgical device (OVD).


METHODS
This was a prospective, randomized controlled trial. Fifty eyes of 47 patients of senile cataract undergoing phacoemulsification were included. Patients were randomly allocated into two groups of 25 eyes each. Cataract surgery was performed by phacoemulsification with anterior chamber (AC) continuous infusion with balanced salt solution (BSS) plus and ACM without OVD in Group A, and in Group B, phacoemulsification was performed using OVD with BSS plus. Corneal endothelial cell count and pachymetry were performed preoperatively and postoperatively on day 1, day 7, and day 30. The mean increase in pachymetry was 4.86%, 2.94%, and 1.94%, (Group A) and 5.95%, 3.94%, and 0.51%, (Group B) on first, seventh, and 30 th postoperative day respectively. The difference between the percentage increase in pachymetry between the two groups was not significant at day 1 ( P = 0.441), day 7 ( P = 0.298), and day 30 ( P =0.174) postoperatively. The density of endothelial cells decreased postoperatively (day 30) by 7.38% (Group A) and 7.47% (Group B) without any significant statistical difference ( P = 0.983) between two groups.


CONCLUSIONS
Use of ACM for continuous AC infusion and omission of OVD during phacoemulsification did not cause significant difference in corneal swelling or endothelial cell loss in the immediate postoperative period up to one month.
Nayak
B K
BK
Ophthalmology Department, P.D. Hinduja National Hospital and MRC, Veer Savarkar Marg, Mumbai - 400 016, India. drbknayak@gmail.com
Jain
Elesh Kumar
EK
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000867:Anterior Chamber / Q000187:drug effects*; D001639:Bicarbonates / Q000008:administration & dosage*; D002452:Cell Count; D003316:Corneal Diseases / Q000209:etiology*; D004338:Drug Combinations; D004728:Endothelium, Corneal / Q000473:pathology*; D005260:Female; D005978:Glutathione / Q000008:administration & dosage*; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D007431:Intraoperative Complications; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000379:methods*; D011446:Prospective Studies; D055675:Viscosupplements / Q000008:administration & dosage
D001639:Bicarbonates; D004338:Drug Combinations; D055675:Viscosupplements; C013003:glutathione-bicarbonate-Ringer solution; D006820:Hyaluronic Acid; D005978:Glutathione