Safety of Active Phacoemulsification Fluidics with Bevel-down Phaco-tip on Corneal Endothelial Cells

ABSTRACT

Purpose@#To evaluate the safety of active phacoemulsification fluidics with a bevel-down phaco-tip on corneal endothelial cells in patients with various corneal endothelial cell densities (ECDs). @*Methods@#One hundred and seventy-three eyes of 111 patients who underwent cataract surgery using active phacoemulsification fluidics with a bevel-down phaco-tip technique were consecutively enrolled. We analyzed the postoperative changes in corneal parameters including ECD and clinical factors associated with percent change in ECD. @*Results@#Preoperative mean ECD was 2,511.02 ± 463.14 cells/mm2 (range, 540-3,390 cells/mm2). There was a significant change in postoperative ECD (-50.70 cells/mm2, p < 0.017), and no significant change in hexagonality or coefficients of variation. A higher preoperative mean ECD (B = -0.010, p < 0.001), a higher grade of nucleus sclerosis (B = -3.002, p < 0.001), and a younger age (B = 0.167, p = 0.040) were associated with a larger percent change in ECD. @*Conclusions@#There was very low ECD loss after active phacoemulsification fluidics with a bevel-down phaco-tip. The lower preoperative ECD was not a risk factor for postoperative ECD loss. Therefore, we suggest that active phacoemulsification fluidics with a bevel-down phaco-tip technique can be performed safely in patients with low ECD when nuclear sclerosis is not severe.