Aim: To evaluate the effect of phacoemulsification and SICS on the endothelial cell count. Introduction: Cataract is an important and prevalent cause of blindness worldwide. Phacoemulsification and manual small incision cataract surgery are widely practiced today. Corneal transparency is maintained by a single layer of endothelial cells, which have the ability to pump out water from corneal stroma against an osmotic gradient. Some degree of corneal endothelial loss following surgery is expected. SICS requires a great deal of maneuvering and thus direct contact with the endothelium leads to cell loss. Cell loss in phacoemulsification is dependent on the anterior chamber depth, phaco energy and method used to emulsify the nucleus, and surgical skill. Materials and Methods: This is one-year observational follow-up study of 100 patients, who were divided into two groups. Group A had 50 patients who underwent phacoemulsification and Group B had 50 patients who underwent SICS. TOPCON specular microscope was used to record the endothelial cell count preoperatively, 7 days postoperatively, and 42 days postoperatively. Results: The mean endothelial cell loss at 1 week and 6 weeks after surgery was more in Group B (278 cells/mm2; 400 cells/mm2) compared to Group A (278 cells/mm2; 400 cells/mm2) respectively, but this difference was not statistically significant. p > 0.05. Conclusion: There was no statistically or clinically significant difference between phacoemulsification or SICS in terms of endothelial cell loss.

Keywords: Endothelial cell count, Phacoemulsification, SICS, Specular microscopy.