Assessment of safety profile of phacoemulsification in hard cataract

Abstract

Purpose: The aim of the study was to assess safety of phacoemulsification in hard cataract by evaluating the post-operative endothelial cell loss and visual acuity. Materials and Methods: This is a hospital-based, prospective study conducted on 70 eyes of 70 patients with hard cataract. At the time of admission, detailed evaluation of anterior segment using slit lamp bio microscopy was done and cataract graded using LOCS III. Posterior segment was evaluated using indirect ophthalmoscopy under 20D/B-Scan. All patients with hard cataract underwent phacoemulsification procedure. The visual acuity and endothelial cell density assessed using Snellens chart and specular microscopy pre-operatively and post-operatively on Day 1, Day 7, and Day 30, respectively. Descriptive statistics, namely, mean, standard deviation to express continuous variables wherever applicable. Correlation between endothelial cell loss and cataract grading and correlation between final endothelial cell loss and final best-corrected visual acuity (BCVA) is analyzed by using Pearson’s Chi-square test and Pearson’s correlation coefficient. P value <0.05 is considered as statistically significant. Results: Among 70 eyes, 40 (57.1%) had NO4-NC4, 18 (25.70%) had NO5-NC5, and 12 (17.1%) had NO6-NC6 cataract grading. The endothelial cell loss was 4.28%, 6.19%, and 7.15% on post-operative day 1, 7, and 30, respectively. There was a positive correlation showing that, as the cataract grading increased the endothelial cell loss increased too. The BCVA of 6/9 was achieved in 2 (2.8%), 6/6 in 68 (97.2%) at the end of four weeks. Conclusion: Although density of cataract has unfavorable influence on early post-operative corneal endothelial cell loss, it did not significantly influence final BCVA. The technique of phacoemulsification for hard nuclear cataract is worthy to be spread due to safety, effectiveness with good visual outcomes.