Corneal Endothelial Cell Loss between the Kongsap Manual Phacofragmentation and Phacoemulsification†
Pipat Kongsap MD*
Affiliation : † The present study was presented in part at the Congress of the International Society of Refractive Surgery of the American Academy of Ophthalmology (May 26th 2007, Beijing, China) The present study was supported in part by the Prapokklao Hospital Reseach Fund, Prapokklao Hospital, Chanthaburi, Thailand The author has no financial or proprietary interest in the products mentioned in the present article * Department of Ophthalmology, Prapokklao Hospital, Chanthaburi, Thailand Affiliated with Chulalongkorn University, Bangkok, Thailand
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, Small- incision cataract surgery, Phacoemulsification, Intraocular lens implantation
