Comparative Analysis of Corneal Endothelial Cell Loss After Phacoemulsification in Microcornea versus Normal-Sized Corneas.

Authors

Tianyu Zheng, Peimin Lin, Ao Miao, Yating Tang, Yongxiang Jiang, Jie Xu

Published in

Clinical ophthalmology (Auckland, N.Z.). Volume 20. Pages 616945. Epub Jul 08, 2026.

Abstract

Phacoemulsification is inevitably accompanied by loss of corneal endothelial cells, and microcornea eyes with crowded anterior segments may be more susceptible to this damage.
This study aimed to compare endothelial cell loss (ECL) after cataract phacoemulsification surgery between eyes with microcornea and those with normal-sized corneas.
This retrospective study included 50 eyes from 50 patients with microcornea and 120 eyes from 120 patients with normal-sized corneas who underwent phacoemulsification. Demographic data and biometric parameters were evaluated preoperatively. Postoperative corneal endothelial cell parameters were measured 3 months after surgery.
Compared with the normal controls, the microcornea group had a shallower anterior chamber, thicker lens and shorter white-to-white distance (WTW) (P < 0.01). Additionally, at 3 months postoperatively, the microcornea group had significantly greater ECL (662.20 ± 496.79 cells/mm²) than the control group did (360.53 ± 364.29 cells/mm2) (P < 0.001). The increase in the mean cell area in the microcornea group (185.38 ± 144.04 μm²) was significantly greater than that in the control group (75.56 ± 92.48 μm²) (P < 0.001). Multiple regression analysis revealed that WTW (Beta=-0.330, P<0.001) and average phaco energy (Beta=0.288, P=0.030) were significant determinants of postoperative ECL in patients with normal-sized corneas. WTW was also a statistically significant risk factor for ECL in all patients (Beta=-0.331, P<0.001).
Compared with normal-sized corneas, microcorneas were more prone to endothelial cell loss after phacoemulsification. WTW was a significant risk factor for postoperative ECL. Preoperative measurement of WTW may serve as a useful risk stratification tool to identify patients who may require additional endothelial protective measures during cataract surgery.

PMID:
42438753
Bibliographic data and abstract were imported from PubMed on 13 Jul 2026.

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