A descriptive study of correlation between micro-coaxial phacoemulsification parameters and post-operative endothelial cell loss in noncomplicated Phacoemulsification surgery

• Dr Hanumant Rangnath Mandlik,  
• Dr Aishwarya Jayant Pandharikar,*  
• Dr Sakshi Ravikant Patil,  
• Dr Kamlesh Najukram Lanje,  
• Dr Ajit Kamalakar Joshi,  
• Dr Rajesh Balkrishna Gotekar

Abstract

Purpose: To study correlation between micro-coaxial phacoemulsification parameters and post-operative endothelial cell loss in noncomplicated Phacoemulsification surgery Methods: In this prospective study, a 150 consecutive cases of cataract patients with different grades of nuclear hardness, underwent microcoaxial phacoemulsification through a 2.8-mm clear corneal incision. Associate Alcon Infiniti Vision System with Ozil scientific discipline (Alcon Laboratories) was used with associate Ozil torsional handpiece and a Kelman style 45° phacoemulsification tip. Phacoemulsification parameters after cataract surgery as well as pre and post-op endothelial cell count was recorded. Results: The study included 150 cases of age-related cataract whose mean age was 64.5 years . There was a highly statistically significant endothelial cell loss (P < 0.001) ranging from 65-1675 cells/mm2 .The percentage of postoperative EC Loss% ranged from 3.63% to 16.42% with a median (interquartile range) of 10.24% (4.32% to 14.67%). A significant positive correlation (p<0.001) was found between the EC Loss% and different phacoemulsification parameters including CDE , tortional time and volume . Also, EC Loss% was significantly correlated with the grade of nuclear opalescence (P = 0.045). Conclusion: Cataracts with increased nuclear hardness require more phacoemulsification power and consequently increased CDE leads to higher endothelial cell loss. Prolonged aspiration time and the use of large amounts of irrigating fluid during phacoemulsification for any reason also ends with increased endothelial cell damage .

Keywords

alcon,infinity,endothelial cell count,specular,torsional,aspiration volume,cumulative dispersed energy