title: Endothelial cells and central corneal thickness after modified sutureless manual small-incision cataract surgery.
abstract: OBJECTIVE
  Manual small-incision cataract surgery (MSICS) is a viable method for cataract surgery around the world. We evaluated the impact of a modification of MSICS, in which an anterior chamber maintainer is used throughout the surgery with the addition of ocular viscoelastic device prior to nucleus removal (M-MSICS), on the corneal endothelium.
  
  
  METHODS
  This prospective study comprised patients randomly assigned for cataract surgery who underwent M-MSICS. Patients underwent corneal endothelial counts by a noncontact specular microscopy in the center and at 12 and 6 o'clock position as well as central corneal pachymetry (CCT) preoperatively, and at 1 week and 1 and 3 months postoperatively.
  
  
  RESULTS
  Twenty-one eyes were included, 16 of which completed the entire follow-up. There was a statistically significant difference in endothelial cell loss at the center of the cornea at 1 week postoperatively (p = 0.003). However, there was no significant difference in endothelial cell measurements between preoperative and other postoperative timepoints at the center of the cornea. In addition, no significant difference was found in the 12 and 6 o'clock measurements at all timepoints. There was a mild but statistically significant increase in CCT at the center of the cornea at 1-week and 1-month postoperative measurements as compared to preoperative measurement (p<0.05). By postoperative month 3, CCT had returned to baseline level.
  
  
  CONCLUSIONS
  Modified MSICS offers a viable enhancement of MSICS, with mild and transient impact on the corneal endothelial cell density and corneal pachymetry.
authors.affiliation: Department of Ophthalmology, Tel-Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Dafna
authors.initials: D
authors.lastname: Goldenberg
authors.forename: Zohar
authors.initials: Z
authors.lastname: Habot-Wilner
authors.forename: Yoseph
authors.initials: Y
authors.lastname: Glovinsky
authors.forename: Irina S
authors.initials: IS
authors.lastname: Barequet
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000473:pathology*; D002387:Cataract Extraction / Q000379:methods*; D002452:Cell Count; D003315:Cornea / Q000601:surgery*; D042783:Endothelial Cells / Q000166:cytology; D004728:Endothelium, Corneal / Q000473:pathology*; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012590:Sclera / Q000601:surgery; D013536:Suture Techniques; D055682:Viscoelastic Substances
chemical_list: D055682:Viscoelastic Substances; D006820:Hyaluronic Acid