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Original ArticleOpen Access
Corneal Endothelial Cell Loss between the Kongsap Manual Phacofragmentation and Phacoemulsification
Kongsap P 
Objective: To compare corneal endothelial cell loss between the Kongsap manual phacofragmentation and
phacoemulsification.
Material and Method: One hundred two eyes with age-related cataract were randomized to undergo either
the Kongsap manual phacofragmentation (Group 1, 52 eyes) or phacoemulsification surgery (Group 2, 50
eyes) with implantation of a posterior chamber, foldable, acrylic intraocular lens performed by one surgeon.
The main parameters were corneal endothelial cell density (ECD), best corrected visual acuity (BCVA), and
intraoperative and postoperative complications. Follow-up visits were scheduled at 1, 4, and 12 weeks.
Results: Pre-operatively, the mean ECD in Group 1 was 2,350 + 229 cells/mm2 and in Group 2 was 2,429 + 263
cells/mm2 (p = 0.112). Mean ECD decrease was 7.61% in Group 1 and 7.19% in Group 2 at the end of 12
weeks. The 95% confidence intervals of the mean differences of the endothelial cell loss at 4 weeks and 12
weeks after surgery were -1.87 to 2.04% and -2.77 to 3.63%, respectively. Mean best-corrected visual acuity
at the end of 4 weeks was 0.88 + 0.22 in Group 1 and 0.82 + 0.24 in Group 2 (p = 0.117 ). There was no
statistical difference between the groups in intra-operative and postoperative complications (p > 0.05).
Conclusion: The corneal endothelial cell loss after cataract surgery with the Kongsap manual
phacofragmentation is equivalent to those of phacoemulsification and both surgical techniques allowed
excellent visual results.
Keywords: Cataract surgery, Endothelial cell loss, Endothelial cell count, ECD, Corneal endothelium, Smallincision
cataract surgery, Phacoemulsification, Intraocular lens implantation
phacoemulsification.
Material and Method: One hundred two eyes with age-related cataract were randomized to undergo either
the Kongsap manual phacofragmentation (Group 1, 52 eyes) or phacoemulsification surgery (Group 2, 50
eyes) with implantation of a posterior chamber, foldable, acrylic intraocular lens performed by one surgeon.
The main parameters were corneal endothelial cell density (ECD), best corrected visual acuity (BCVA), and
intraoperative and postoperative complications. Follow-up visits were scheduled at 1, 4, and 12 weeks.
Results: Pre-operatively, the mean ECD in Group 1 was 2,350 + 229 cells/mm2 and in Group 2 was 2,429 + 263
cells/mm2 (p = 0.112). Mean ECD decrease was 7.61% in Group 1 and 7.19% in Group 2 at the end of 12
weeks. The 95% confidence intervals of the mean differences of the endothelial cell loss at 4 weeks and 12
weeks after surgery were -1.87 to 2.04% and -2.77 to 3.63%, respectively. Mean best-corrected visual acuity
at the end of 4 weeks was 0.88 + 0.22 in Group 1 and 0.82 + 0.24 in Group 2 (p = 0.117 ). There was no
statistical difference between the groups in intra-operative and postoperative complications (p > 0.05).
Conclusion: The corneal endothelial cell loss after cataract surgery with the Kongsap manual
phacofragmentation is equivalent to those of phacoemulsification and both surgical techniques allowed
excellent visual results.
Keywords: Cataract surgery, Endothelial cell loss, Endothelial cell count, ECD, Corneal endothelium, Smallincision
cataract surgery, Phacoemulsification, Intraocular lens implantation
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