Comparison of Short-term Corneal Endothelial Changes following Phacoemulsification through a Limbal and Clear Corneal Incision

Yee, Won Mo; Park, Chan Kee; Hahn, Tae Won

Abstract

To compare the central corneal endothelial change following phacoemulsification using two different incision methods, a total of 49 patients (49 eyes) were recruited for prospective study. Forty-nine eyes were divided into two groups according to incision location. In Group 1(n=28), a PMMA IOL was implanted through a 6.5 mmlimbal incision.In Group 2(n=21), a soft foldable IOL was implanted through a 3.5 mm clear corneal incision.Various endothelial cell parameters were measured preoperatively and up to 2 months postoperatively. In Group 1 corneal endothelial cell loss (CECL) was 12.9%, 8.9% and 8.8% at postoperative 1 week, 1 month and 2 months respectively. In Group 2 CECL was 13.9%, 12.6%, 10.1%,respectively. The CECL was greater as ultrasound time and power increased, which was more profound in Group 2. The morphologic endothelial parameters showed greater changes at postoperative 1 month. However, no statistically significant difference was noted in those parameters between two groups. From these results, phacoemulisification with 6.5 mm limbal incision produced slightly less CECL than that with 3.5 mm clear corneal incision. However, the difference was not significant. Phacoemulsification with clear corneal incision showed acceptable corneal endothelial cell loss but this technique requires precaution in cases of low preoperative endothelial cell density, complicated cataract and hard nucleus.