Evaluation of the effects of cataract surgery on the cornea endotel by phacoemulsification and mini-nuc techniques

Aim: Evaluate the morphological (cell density, coefficient of variation and hexagonality) and functional (central corneal thickness) effects of cataract surgeries performed by phacoemulsification (PHACO) and mini-nuc techniques in the corneal endothelium. Material and Method: A total of 60 patients who were admitted for low vision and underwent 30 mini-nuc technique (Group 1) and 30 phacoemulsification methods (Group 2) were included in the examination. Preoperative and postoperative first and third month non-contact specular microscopy (Konan CellChek XL) was performed in all patients. Endothelial cell density (CD) (cell/mm2), coefficient of variation (CV) (%), hexagonality (HEX) (%) and central corneal thickness (CCT) (μm) were recorded. All parameters were compared statistically between groups and p <0.05 was considered significant. Results: The mean age was 64.83±9.47 (56–86 years), years in group 1 and 64.17±9.57 (45–80 years) years in group 2. There was no statistically significant difference in the mean CD at 1 month because the two groups were compared with each other (p:0,626). At the end of the first month, the mean CD loss rate was similar in the two groups (16.26% and 21.08%, respectively). However, there was a statistically significant difference between the two groups at 3 months (p: 0.002). At the end of the 3rd month, CD loss was less in the mini-nuc group (8.91% vs. 23.09%). The mean preoperative CCT value was 33.67 µm (6.38%) in the first month and 12.6 (2.39%) 3.m in the first month, and 10 in the first month in group 2. There was an increase of 10.03 µm (1.84%) and a decrease of 11.93 (2.39 %) in the third month. There was a statistically significant difference between the groups when preoperative CCT was compared to the postoperative 1st and 3rd months (p <0.001, p: 0.002). Conclusion: Mini-nuc technique is a more reliable method to maintain endothelial density than PHACO method. Especially in cases with endothelial number of 1200 cells/mm2, mini-nuc technique can be applied. On the other hand, pachymetry reached the preoperative value in the mini-nuc technique in a longer time and in the PHACO group it reached preop value in the first month. Key words: Mini-nuc, Phacoemulsification, Endothelium, Pachymetry, anterior chamber maintainer