Purpose: To evaluate the effect of various intra operative surgical complications on Central Corneal Endothelial Cell Density and Central Corneal Thickness

Methods: A prospective study comprising of 222 patients who underwent small incision cataract surgery, which were divided into three groups.

G1 -Irrigating vectis technique-73 patients

G2-Sandwich technique-75 patients

G3 -Visco expression technique-74 patients.

All patients underwent complete ophthalmic examination and biometry followed by measurement of central corneal thickness, specular microscopy (endothelial images) was performed at baseline (preoperative) and postoperatively at 1week, 2 weeks, 1 month and 3 months.

Results: In our study, out of 222 patients, 180 patients had uneventful and 42 patients had complicated surgeries. In that 42 complicated surgeries,

-11 patients had instrumental trauma (26.2%) which caused 25.2% endothelial cell loss (p value 0.001) and 5% increase in CCT.

-14 patients had Iris prolapse (33.3%) which caused 19.1% cell loss (p value 0.001) and 0.9% increase in CCT

-7 patients had IOL Contact (16.7%) which caused 13.1% cell loss (p value 0.003) and 1.9% increase in CCT

-9 patients had vitreous loss (21.4%) which caused 11.5% cell loss (p value 0.039)  and 0.9% increase in CCT and 1 patient had Iris posterior capsular rent  (2.4%) which caused 11.3% cell loss and 0.9% increase in CCT at 3 months post operatively.

In all 42 complicated surgeries, average 10.6% cell loss and 5.8% increase in CCT was found.

In all 180 uneventful surgeries, average 9.5% cell loss and 3.48% increase in CCT was found.

Conclusion: Percentage of endothelial cell loss and increase in central corneal thickness was more in complicated surgeries, than uneventful surgeries.

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Dr Sachin Tammannavar

Karwar Institute of Medical Sciences, Karwar- 581301(India)