The Corneal Endothelial Protective Effect of Soft Shell Technique in Cataract Surgery

ABSTRACT

PURPOSE: To evaluate the efficacy and safety of soft shell technique (SST) to reduce corneal endothelial damage during cataract surgery. METHODS: Cataract surgery was performed in thirty five eyes using SST with Healon and Viscoat , and in thirty five eyes with Healon alone as a control group. The corneal parameters such as corneal thickness, cell density, hexagonality, and the coefficient of variance were evaluated. RESULTS: The mean central corneal thickness in the control group was 533.1 +/- 34.9micrometer before surgery and 549.1 +/- 34.3micrometer at one week after surgery. The difference in corneal thickness was statistically significant (p<0.01). However, in the SST group, the change in corneal thickness before and after surgery was not statistically significant (529.5 +/- 36.3micrometer, 536.0 +/- 36.9micrometer, respectively). There were statistically significant changes in cell density after surgery in both groups. The results for the control group were 2478.5 +/- 319.7/mm2 before surgery and 1861.9 +/- 109.1/mm2 at 3 months after surgery. The result for the SST group were 2571.2 +/- 256.5/mm2 before surgery and 2107.2 +/- 374.1/mm2 at 3 months after surgery. The rate of endothelial cell loss at 3 months after surgery was smaller in the SST group (19%) than in the control group (25%). The coefficient of variance and hexagonality were normalized at one week after surgery in SST group. CONCLUSIONS: These results suggest that SST is effective in protecting corneal endothelial cells during cataract surgery, providing better results in the early postoperative period.