Efficacy of manual small incision cataract surgery in preventing the endothelial cell loss

Abstract

Background: Every year 5 million cataract surgeries are performed in India. Two major procedures are used to conduct cataract operations either MSICS/Phecoemulisfication. In both the procedures the loss of endothelial cells are observed. The present study is based on comparison of endothelial cell loss in both the procedures. Objectives: The aim of the study is to compare endothelial cell loss after manual small incision cataract surgery (MSICS) and Phacoemulsification by specular microscopy. Methods: Present study was conducted at Sarojini Devi Eye Hospital, Hyderabad from 2013-14. Total number of eyes studied was 100 in 100 study subjects who were age and sex matched and divided into two groups of 50 eyes of 50 study population. Group I patients underwent Phaecoemulsification & Group II with MSICS by the same operating surgeon from 2013-14. The patients were evaluated on first post operative day, first week, 6 weeks and 6 months for endothelial density. Endothelial density was evaluated through Specular Microscopy EM 3000, Tomey. Best image of 15 shots was taken to evaluate endothelial density. Results: Mean age in both the groups was 58 and 59 years. Equal number was taken sex wise in both the groups. The mean endothelial loss was 200 cells/mm2 & 250 cells/mm2 in Group I & II respectively. Conclusions: In phacoemulsification group, the maneuvering was performed in the capsular bag and newer advanced phacoemulsification units with better fluidics reduced the chances of endothelial damage. In MSICS group, Visco-expression of the nucleus significantly reduced the endothelial cell loss.

Keywords

• pachymetry
• phaecoemulsification
• specular microscopy