To Compare the Changes in the Corneal Endothelium Post Phacoemulsification Surgery with Balanced Salt Solution vs. Viscoelastic Device

Abstract

Introduction: The corneal endothelial layer cannot regenerate. During phacoemulsification, it is exposed to damage. It is necessary to determine the causes of endothelial damage and replace them with less damaging alternatives. Aim: To compare the endothelial cell density and morphology in patients undergoing phacoemulsification with and without the use of viscoelastic device. Materials and Methods: This was a hospital based prospective interventional study. Fifty patients with cataract were included, who underwent cataract extraction by phacoemulsification. Among 25 patients viscoelastic device (Group I) was used. In the other 25 (Group II) the Anterior Chamber (AC) was maintained using continuous infusion of Balanced Salt Solution (BSS). Specular microscopy was done preoperatively and on 14th postoperative day. Student’s paired and Unpaired t-test was done. SPSS 24.0 version was the software used and p<0.05 was considered as level of significance. Results: The endothelial cell density reduced from 2346.16±237.04 cells/mm2 to 2327.88±234.93 cells/mm2 in Group I and from 2347.96±215.55 cells/mm2 to 2320.28±220.82 cells/mm2 in Group II on 14th postoperative day. The percentage of hexagonal cells reduced by 8.33% in Group I and 8.37% in Group II on the 14th postoperative day. Conclusion: Implantation of IOL using BSS infusion seems to be a faster alternative to use of viscoelastic device in experienced hands without higher endothelial cell loss rates since there was no significant difference in corneal density or morphology between the two groups on the 14th postoperative day.

Keywords

• anterior chamber maintainer
• endothelial cell density
• endothelial morphology
• specular microscopy