Short-term Change of Corneal Endothelium after Phacoemulsificatin using Phaco-drill Technique

ABSTRACT

Phaco-drill technuque, is a method of phacoemulsifying cataractous lens with a bevel down position of phacotip, thus concentrating vacuum and ultrasonic power on center of the lens. This enables the phacoemulsification to be completed with a lower setting of energy. In this study, we evaluated the efficacy of the phaco-drill technique by measuring corneal endothelial cell damage. Since August 1997, we examined 170 patients who had under-gone phacoemulsification using phaco-drill technique, for uncorrected visual acuity, number, shape and size of corneal endothelial cell, and corneal thickness before and 2 months after surgery. the mean visual acuity was 0.26+/-0.24 before operation,and the mean visual acuity at 1 day and 2 months postlperatively was 0.59+/-0.32 and 0.82+/-0.26, respectively. The mean time of phacoemulsification was 58+/-41 seconds, and the average power(surgeon mode)was 8.6+/-0.26%. Mean volume of irrigating solution used in the operation was 116.12+/-52.10cc and that of aspirated solution was 63.34+/-30.37cc. The number of endothelial cells decreased from 2450+/-308.6 cell/mm2 before operation to 2234+/-372.2 cell/mm2 2 months after operation(9.2% decrease). The size of endothelial cells increased from 33.78+/-5.53/micrometer(2) before operation to 34.70+/-5.79/micrometer(2) 2 months after the operation(2.7% increase). The regularity of the cells (hexagonality) showed a decrease of 3%, from 57.47+/-10.16 before operation to 55.81+/-10.49% 2 months after the operation. The corneal thickness increased from 528+/- 36micrometer before operation to 590+/-8micrometer 1 dat(11.7% increase) and 531+/-4micrometer(0.5% increase) after the operation. From the results of this study we suggested that phaco-drill technique might be one of effective methods of phacoemulsification for less damage of corneal endothelial cells and less fluid consumption.