Comparison of Corneal Endothelial Cell Count Changes in Patients Undergoing Phacoemulsification Vs Sics at Tertiary Care Hospital

Background: The corneal endothelium is essential for maintaining corneal transparency. Endothelial damage during cataract surgery can adversely affect visual outcomes, with Phacoemulsification and Small Incision Cataract Surgery (SICS) causing varying degrees of endothelial stress. Postoperative endothelial cell density assessment helps determine the relative safety of these techniques. Aims: To evaluate and compare corneal endothelial cell count (ECC) changes following Phacoemulsification and SICS performed by a single experienced surgeon. Settings and Design: Hospital-based longitudinal observational study. Methods and Material: A total of 82 patients aged 41–80 years were enrolled, with 41 undergoing Phacoemulsification and 41 undergoing SICS. All participants received detailed preoperative ocular examinations. Endothelial cell density was measured using non-contact specular microscopy before surgery and at 2 and 6 weeks postoperatively. Statistical analysis used: Chi-square test, unpaired t-test, ANOVA test. Results: The mean preoperative ECC was comparable between the Phacoemulsification (2642.3 ± 171.6 cells/mm²) and SICS (2602.8 ± 184.3 cells/mm²) groups. Endothelial cell loss was significantly higher with Phacoemulsification at both 2 weeks (276.40 ± 54.25 vs. 195.60 ± 42.86 cells/mm²) and 6 weeks (394.70 ± 65.78 vs. 296.00 ± 57.42 cells/mm²) compared to SICS (p < 0.001). Conclusions: SICS demonstrated lower endothelial cell loss and remains a safe, efficient, and cost-effective option, particularly in patients with advanced cataracts.