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J. Richard, L. Hoffart, H. Proust, B. Ridings, J. Conrath; Corneal Central Pachimetry and Corneal Endothelial Damage After Cataract Surgery Using Traditional Phacoemulsification versus Fluid Based System Extraction. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1079.
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To compare central corneal thickness and central corneal endothelial cell damage after conventional ultrasound phacoemulsification versus fluid-based phacoextraction.
In a prospective randomized study, 42 eyes of 42 patients were divided in two groups of 21 patients each which underwent cataract surgery.Conventional ultrasound system was used in group 1, and a fluid-based system method in group 2. " Divide and conquer" phacoextraction technique with capsular bag lens implantation was performed in both groups.Only cataracts graded up to Nuclear opalescence 4.9 in the LOCS III classification were included in the study. We analyzed 5 different corneal parameters: endothelial cell density ( ECD ), hexagonality rate , endothelial cell area ( ECA ), coefficient of variation in cell size ( CV ) and central corneal pachymetry(CCP), before surgery and at 7, 30 and 90 days post-operatively .
Average Nuclear Opalescence was not significantly different between groups 1 and 2 (P=0,908). ECD decreased in both groups with a different curve. Maximum cell loss was observed at one month after surgery in group 1, whereas the maximum was seen at one week in group 2. There was no significant difference (p = 0.23 ).ECA increased at one month for the group 1 and at one week for the group 2 (p>0.180).An acute increase of CCP was found at one week for both groups (CCP: p=0.514).The hexagonality rate decreased in both groups with a similar curve and there was no significant difference.CV increased at one month in both groups with a similar curve (p=0.395).
The Fluid-based extraction system was as safe as conventional ultrasound for cataract extraction for lenses graded up to nuclear opalescence 4.9 in the LOCS III classification. There was no mean difference in endothelial corneal damage between these two different techniques.
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