The Effect Of ECCE And Phaco On Corneal Endothelium And Central Corneal Thickness: A Systematic Review

Objectives:To evaluate postoperative endothelial damage and postoperative central corneal thickness after extracapsular cataract extraction (ECCE) and phacoemulsification (Phaco).Methods:We searched the Cochrane Central Register of Controlled Trials (issue 3,2008), MEDLINE (1966 to Nov 2010),Embase(1980 to Nov 2010),and CMB-disk(1979 to Nov 2010). We also hand searched relevant journals and conference proceedings. Data were extracted by two reviewers independently using an extraction form.The Cochrane Collaboration's RevMan 5.0 software was used for statistical analysis.Results:Four RCTs involving 704 participants (704 eyes) with cataract were included,1-12 months follow-up. Meta-analysis shows there were significant difference between ECCE and Phaco in postoperative corneal endothelium (WMD55.26,95%CI 0.79 to 109.73),P=0.05,and in central corneal thickness(WMD28.21,95%CI 12.29 to 44.13),P=0.0005.Conclusion: Our Systematic Review shows compared with ECCE,Phaco induced more corneal endothelial cell loss and increased central corneal thickness more. Since the sample size of the included trials are relatively small, more well-designed large-scale RCTs are required.