Corneal endothelial cell loss between the Kongsap manual phacofragmentation and phacoemulsification.

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.