Effect of Phacoemulsification Power on Corneal Endothelial Cell Count and Corneal Thickness in Age Related Cataract Surgery

Objective: To determine the effect of phacoemulsification power on corneal endothelial cell count and corneal thickness in age related cataract. Design: It was a quasi-experimental study. Study Settings: The study was conducted at Department of Ophthalmology Unit III, Institute of Ophthalmology Mayo Hospital/KEMU Lahore from 18/04/2018 to 17/10/2018. Material and Methods: This study involved 140 patients of both genders aged between 50-60 years undergoing age related cataract surgery. A written informed consent was obtained from every patient. Per-operative phacoemulsification power and time were recorded. Post-operative endothelial cell count and corneal thickness was taken on 1st, 7th and 14th postoperative day. Three readings were taken and mean value was considered. Results: There was slight female predominance (1:1.2) with a mean age of 55.21 +/- 3.0 years. Baseline corneal thickness and endothelial cell count's mean +/- SD was 548 +/- 7.4 mu m and 2136.5 +/- 104.6 cells/mm(2) respectively. At week 14, the mean corneal thickness was 548.7 +/- 7.4 mu m at baseline was 572.02 +/- 15.25 mu m (4.2 +/- 2.2% of the baseline) but was still significantly higher than at the baseline (p=0.001). The mean endothelial cell count was in Nuc Cat grade 1 where high power was used was 2376.6 +/- 104.6 cells/mm(2) at baseline and decreased to 2173.5 +/- 110.35 cells/mm(2) (8.5 +/- 2.79% of the baseline) at 14 weeks. Compared to the baseline, this decrease in endothelial cell count was significant (p=0.001). Similar, results were seen in other grades of cataract and with low power as well. When high power were subjected to different grades of cataract, high time showed more cell loss as compared to low time with same power (p=0.02). Conclusion: A higher power-longer time, low power-longer time showed increased endothelial cell loss and high power-longer time, lower power-longer time predicted increased corneal thickness. So, phacoemulsification power and time played a vital role in damaging endothelial cell with secondary increase in corneal thickness.