MANUAL NUCLEOFRAGMENTATION AND ENDOTHELIAL-CELL LOSS

Purpose: To compare corneal endothelial cell loss with two cataract su rgery techniques: manual nucleofragmentation performed with the Keener nucleus divider and planned extracapsular extraction. Setting: Depart ment of Ophthalmology ''Memorial Cristobal Garrigosa,'' Hospital de l' Esperanca, Universitat Autonoma de Barcelona, Spain. Methods: Contact specular microscopy was performed before and 8 weeks after surgery in 51 patients who had been prospectively randomized into 2 groups: 26 pa tients had manual nucleofragmentation (NF) with the Keener divider and 25, planned extracapsular cataract extraction (ECCE). The analyzed pa rameters were preoperative and postoperative endothelial cell density and variations in cell size (polymegethism) and cell shape (pleomorphi sm). The results were compared and statistically analyzed. Results: Th e mean percentage of endothelial cell loss in the NF group was 11.08% and in the ECCE group, 9.86%. This difference was not statistically si gnificant. Postoperative variation in cell shape and size did not diff er significantly between the two groups and was fairly constant. Concl usion: The percentage of endothelial cell loss that occurred with manu al NF using the Keener nucleus divider was similar to the one that occ urs with other cataract surgery techniques. The small variation detect ed in postoperative endothelial morphology suggests that this endothel ial cell population is stable.