Objective:

To evaluate endothelial cell loss in patients after uncomplicated phacoemulsification comparing data from novice surgeons and expert surgeons.

Method:

An observational and prospective study was conducted in which 50 consecutive randomized eyes were evaluated in two groups of 25 eyes each. An endothelial cell count with specular microscopy was performed preoperatively and one month after surgery. Eyes with complicated cataracts were excluded.

Results:

Most of the patients were women, with a mean age of 75.5 years. The decrease in endothelial cell density one month after surgery was significant both in eyes operated by expert surgeons and novice surgeons, with a loss of 14.8% and 15.6%, respectively, with no statistically significant difference (p = 0.491). Furthermore, the correlation between both groups was 0.58 (p = 0.0094). Cell loss in eyes operated by novice surgeons showed a good correlation (0.577) with the cumulative dissipated energy during phacoemulsification (p = 0.0025), contrary to the results obtained with expert surgeons where this correlation could not be demonstrated. The total cumulative dissipated energy used by novice surgeons was significantly higher (p = 0.045); 63% more than expert surgeons.

Conclusions:

Phacoemulsification resulted in significant corneal endothelial cell damage with similar figures for both groups, showing a good correlation between them. Concerning endothelial cell loss, the safety of the procedure performed by novice surgeons is equivalent to that performed by experts.

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