DOI: 10.25259/gjcsro_1_2024 ISSN: 2832-1316

Comparison of endothelial cell loss in Viscoless phacoemulsification versus soft shell technique of phacoemulsification: A retrospective study

Ankita Vijay Mulchandani, Abhijeet Umesh Desai, Gurmanik Kaur, Rohit Modi


The purpose of this study was to compare the consequences of soft shell and viscoless technique on corneal endothelial cells (CECs) in cataract patients after phacoemulsification.

Materials and Methods:

This is a retrospective study. A total of 206 eyes of 139 patients (75 males and 64 females) who underwent phacoemulsification surgery during the period from September 2019 to December 2019 were enrolled in the study. The patients who underwent phacoemulsification were divided into two groups depending on the type of surgery performed, that is, viscoless or soft shell technique. The pre-operative and post-operative records were compared. The primary outcome measure was endothelial cell count (ECC) measured at baseline and postoperatively. The differences between the two groups were analysed statistically. The study was done at Sohum Eye Care Centre, Mumbai, India.


No statistically significant differences were observed between the two groups in terms of age, gender, diabetic status and cumulative dissipated energy (CDE), as P > 0.05. The inter-group mean difference between CDE did not differ significantly (P = 0.0626 and 0.1075, for 1 and 3 months inter-group comparison) between the two groups. However, a statistically significant mean difference of 99.9516 cells/mm2 (P < 0.0001), 116.4146 cells/mm2 (P = 0.0031) after one month and 90.4468 cells/mm2 (P = 0.0051), 145.2895 cells/mm2 (P < 0.0001) 3 months of surgery, between pre- and post-operative ECC, was observed in group 1 and group 2, respectively. The values of Pearson’s correlation (r = −0.3 to +0.3) suggested a very weak and non-significant strength of association of endothelial cell loss with age, gender, diabetic status and CDE postoperatively. Intergroup post-operative endothelial cell loss did not show any significant difference after 1 (P = 0.0644) and three months (P = 0.052) of phacoemulsification.


Viscoless phacoemulsification surgery may be recommended in appropriate patients to avoid the side effects of ophthalmic viscosurgical devices.

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