The Effect On Corneal Endothelium Of Hard Cataract Between Modern Phacomulsification And Extracapsular Cataract Surgery

Objective:To investigate the effect on corneal endothelium in treating hard nuclearcataract by modern phacoemulsification surgery and extracapsular cataract extraction(ECCE).Methods: Totally79cases (92eyes) of senile cataracr patients were divided into twogroups,group1and group2by treatment modality.Group1included43cases(54eyes),23men,average aged71years, was treated with phacoemulsification.Group2included36cases(38eyes),19men,average aged73years was treated withextracapsular cataract extraction (ECCE).Nucleus hardness:IV graph hard nucleuswere49eyes,Vgraph hard nucleus were5eyes in group1. IV graph hard nucleus were30eyes, Vgraph hard nucleus were8eyes in group2. Preoperative visual acuity wasfrom light sensation to0.1.Patients were excluded if they had other eye disorderscapable of compromising vision,such as high myopia, glaucoma, previous intraocularinflammation or trauma,corneal disease. Patients were also excluded if they wereDiabetes mellitus patients.All operation were accomplished by a single surgeon.Central corneal endothelial cell counts were assessed before surgery and3months after surgery by a noncontact specular microscope （Topcon SP-3000noncontact specular microscope and ImageNet analysis system [Topcon, Tokyo,Japan]）. All pictures were captured by the same examiner who was blinded to thesurgical technique. The data was analysised by SPSS13.0.Results:3months after surgery,the proportion of visual（≥0.5） was100%、89%ingroup1and2.There was no significant difference in central corneal endothelial celldensity and average size and percentage of hexagonal cells in any preoperative itemmeasured between the two groups.3month after cataract surgery,the reduction in cell count in group1is12.9%±4.1%,in group2is7.3%±3.7%. There was significantdifference in overall percentage cell loss between the2treatment groups. There wasno difference between the two groups in percentage of hexagonal cells.Conclusions:1.The two cataract surgery will hurt the central corneal endothelialcell，the endothelial cell density become lower and the cell average size becomebigger.2.The operation result is better in phacomulsification.The cell loss is bigger inphacomulsification.3. The central corneal endothelial cell should be acquired beforethe surgery. Phacomulsification is also suited for hard cataract.