Effect of Continuous Ultrasonic Phacoemulsification with Anterior Chamber Maintainer on Corneal Endothelial Damage in Hard Nuclear Cataract

Abstract

Purpose To study the effects of continuous ultrasonic phacoemulsification performed with and without an anterior chamber maintainer (ACM) on corneal endothelial damage in patients with hard nuclear cataract. Methods Sixty eyes in 60 patients with hard nuclear cataract (grade IV), one lesion per eye, were randomly allocated into 2 groups: continuous ultrasonic phacoemulsification with (group A) or without (group B) ACM. The intraoperative accumulated energy complex parameter (AECP), frequency of shallow anterior chamber, and postoperative corneal incision edema, corneal endothelial cell counts, and visual recovery were compared between the groups. Results The intraoperative AECP, postoperative corneal incision edema, and postoperative visual recovery showed no significant differences between the groups (p>0.05). At 1 month postoperatively, the corneal endothelial cell loss rate and hexagonal cell percentage (postoperative compared to preoperative) in groups A and B were 0.117 ± 0.12 and 9.97 ± 9.52% and 0.15 ± 0.73 and 8.5 ± 4.60%, respectively, with no significant difference noted (p>0.05). The endothelial cell mutation rate was significantly lower in group A than in group B at 6.41 ± 6.78% and 28.27 ± 27.95%, respectively (p<0.05). The frequency of intraoperative shallow anterior chamber was significantly lower in group A than in group B (2 vs 17 times, p<0.05). Conclusions Continuous ultrasonic phacoemulsification with ACM is a safe, effective, simple, and easy method to treat hard nuclear cataract and causes minimal damage to corneal endothelial cells. It is an ideal surgical option and is worth popularizing.