title: Comparison of morphological and functional endothelial cell changes after cataract surgery: phacoemulsification versus manual small-incision cataract surgery.
abstract: OBJECTIVE
  To compare the morphological (cell density, coefficient of variation and standard deviation) and functional (central corneal thickness) endothelial changes after phacoemulsification versus manual small-incision cataract surgery (MSICS).
  
  
  METHODS
  Prospective randomized control study.
  
  
  METHODS
  In this prospective randomized control study, patients were randomly allocated to undergo phacoemulsification (Group 1, n = 100) or MSICS (Group 2, n = 100) using a random number Table. The patients underwent complete ophthalmic evaluation and specular microscopy preoperatively and at 1and 6 weeks postoperatively. Functional and morphological endothelial evaluation was Noncon ROBO PACHY SP-9000 specular microscope. Phacoemulsification was performed, the chop technique and MSICS, by the viscoexpression technique.
  
  
  RESULTS
  The mean difference in central corneal thickness at baseline and 1 week between Group 1 and Group 2 was statistically significant (P = 0.027). However, this difference at baseline when compared to 6 week and 1 week, 6 weeks was not statistically significant (P > 0.05). The difference in mean endothelial cell density between groups at 1 week and 6 weeks was statistically significant (P = 0.016). The mean coefficient of variation and mean standard deviation between groups were not statistically significant (P > 0.05, both comparisons).
  
  
  CONCLUSIONS
  The central corneal thickness, coefficient of variation, and standard deviation were maintained in both groups indicating that the function and morphology of endothelial cells was not affected despite an initial reduction in endothelial cell number in MSICS. Thus, MSICS remains a safe option in the developing world.
authors.affiliation: Nayana Superspecialty Eye Hospital and Research Center, Davangere, Karnataka, India ; Department of Ophthalmology, Jayadeva Jagadguru Murugarajendra Medical College, Davangere, Karnataka, India.
authors.forename: Sunil
authors.initials: S
authors.lastname: Ganekal
authors.affiliation: Department of Ophthalmology, Jayadeva Jagadguru Murugarajendra Medical College, Davangere, Karnataka, India.
authors.forename: Ashwini
authors.initials: A
authors.lastname: Nagarajappa
mesh_terms: D002387:Cataract Extraction / Q000379:methods; D002452:Cell Count; D055954:Corneal Endothelial Cell Loss / Q000503:physiopathology; D004728:Endothelium, Corneal / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D018918:Phacoemulsification / Q000379:methods*; D011446:Prospective Studies
keywords: Cataract Surgery; Endothelail Changes; Endothelial Cell Changes; Specular Microscopy