Analysis Of Corneal Endothelial Cell After Cataract Phacoemulsification By Two Different Incisions

Objective: To compare the Uncorrected visual acuity(UCVA),endothelial cell density(ECD),the morphology(coefficient of variation and Hexagonality)of corneal endothelial cells(CECs)changes in 1 week,1 month,3 months after phacoemulsification surgery through temporal clear corneal incision or maximum refractive powerof the cornea radial axial transparent angle incision,to analyze the influence of two different corneal incision phacoemulsification cataract surgery on corneal endothelial cells.Methods: Prospective analysis of 200 patients who were admitted to the First Affiliated Hospital of Hainan Medical College from August 2016 to May 2017 were randomly divided into two groups for surgery.The study of 200 patients were randomly divided into two groups.There were 100 patients in the temporal incision group,with an average age of 66.4±4.6 years,including 45 males in 45 eyes and 55 females in 55 eyes.All patients accepted temporal clear corneal incision phacoemulsification surgery;There were 100 patients in the special incision group,with an average age of 67.1±5.5years,including 52 males in 52 eyes and 48 females in 48 eyes.these patients will accept maximum refractive powerof the cornea radial axial transparent angle incision phacoemulsification surgery.The changes of uncorrected visual acuity,endothelial cell density(ECD),coefficient of variation(CV)and Hexagonality were compared between the two groups Preoperation and after operationin in 1 week,1 month,3 months.Results:1、UCVA was significantly improved in the two groups.There were significant differences in UCVA with the two groups after surgery between the preoperative and the postoperative(1 week,1 month and 3 months)(P<0.05).There was no significant difference in UCVA between 1 week and 1 month,3 months after operation(P>0.05).There was no statistical difference in UCVA between the 1 month and the 3months after surgery(P>0.05).There was no significant difference in UCVA between the two groups in each period.2、ECD was significantly reduced in the two groups.There were significant differences in ECD with the two groups after surgery between the preoperative and the postoperative(1 week,1 month and 3 months)(P<0.05).There was no significant difference in ECD between 1 week and 1 month,3 months after operation(P>0.05).There was no statistical difference in ECD between the 1 month and the 3months after surgery(P>0.05).There was no significant difference in ECD between the two groups in each period.3、CV was significantly enhanced in the two groups.There were significant differences in CV with the two groups after surgery between the preoperative and the postoperative(1 week,1 month and 3 months)(P<0.05).There was no statistical difference in CV between 1 week and 1 month,3 months after operation(P>0.05).There was no statistical difference in CV between the 1 month and the 3 months after surgery(P>0.05).There was no significant difference in CV between the two groups in each period.4、Hexagonality was significantly reduced in the two groups.There were significant differences in Hexagonality with the two groups after surgery between the preoperative and the postoperative(1 week,1 month and 3 months)(P<0.05).There was no significant difference in Hexagonality between 1 week and 1 month,3 months after operation(P>0.05).There was no significant difference in Hexagonality between the 1month and the 3 months after surgery(P>0.05).There was no statistical difference in Hexagonality between the two groups in each period.Conclusion:1、There are no significant differences in the number and morphology of corneal endothelial cells between the two different incisions.The surgical procedure can neglect the influence of corneal endothelial cells due to the position of the surgical incision.The surgeon can choose the surgical incision according to personal habits.Even individualized incisions can be designed based on the patient’s corneal condition.2、No matter how the position of the incision was changed by phacoemulsification,the UCVA was significantly different between the preoperative and the postoperative.There was a significant difference in UCVA between the various periods after surgery and before surgery.There was no significant difference in UCVA between the two groups.