A comparative study of central corneal thickness changes in bevel-up and bevel-down phacoemulsification

Abstract

Introduction: Many techniques that have been developed but the risk for corneal endothelium damage and posterior capsule rupture still exist. It is believed that corneal endothelium is minimally damaged when the tip is bevel down in phacoemulsification surgeries. There is a difference between ophthalmologists with respect to the position of tip in phacoemulsification, and hence we conducted this study. Methodology: Thirty patients were evaluated in this study, both eyes of all the patients were operated using phacoemulsification; the right eye of all patients was operated with the bevel-up phaco tip and the left eye of all patients was operated using bevel-down phaco tip. The central corneal thickness (CCT) was taken and compared on preoperative day, immediate postoperatively, and on postoperative day 1, day 14, and 1 month in bevel-up and bevel-down phacoemulsification. Results: The mean CCT on day 14 in bevel-up phacoemulsification was 593.40 ± 18.11 and in bevel-down phacoemulsification was 585.37 ± 26.60, and on day 30 in bevel-up phacoemulsification was 573.53 ± 16.27 and bevel-down phacoemulsification was 561.80 ± 18.20. It can be observed that there was no significant difference in the CCT on day 0, day 1, and day 14; however, on day 30, there is a significant difference in the bevel up versus bevel down. Conclusion: In our study, it was observed that there was no significant difference in the CCT on day 0, day 1, and day 14; however, on day 30, there is a significant difference in the bevel up versus bevel down. Hence, it is observed that the corneal endothelial loss is less in bevel down when compared to bevel-up phacoemulsification.

Keywords

• cataract
• central corneal thickness
• phacoemulsification