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Purpose: This study was conducted to discover that whether Co-axial micro incision cataract surgery using 1% ultrasound is superior to phacoemulsification using higher powers in terms of corneal endothelial safety over a period of one year. Materials and Methods: This comparative randomized study was conducted from 11-01-2014 to 03-31-2016. Patients with hard cataracts [5.0-6.9 of lens opacities classification system-III] were randomized into four groups and underwent cataract surgery using ultrasound powers of 1%, 5%, 10% and 20% respectively. Post-operatively they were assessed in terms of- corneal endothelial cell loss, co-efficient of variation of cell size, percentage of hexagonal cells and corneal thickness. The other parameters that were investigated were - frequency of significant posterior capsular opacification, best corrected visual acuity and Intraocular pressure variations. Results: This study found that application of 1% ultrasound power is superior to 5%, 10% or 20% power in phacoemulsification cataract surgery in terms of quantitative endothelial cell analysis (endothelial cell density, percentage of loss of endothelial cells, coefficient of variation, central corneal thickness and percentage of hexagonal cells) over one year follow up post-operatively. On comparison all parameters were found to be statistically significant when compared to the application of 20% power. Conclusion: Negative effects of ultrasound power (used in phacoemulsification) on corneal endothelial health have been well documented in the literature. We found that minimizing this power to 1% is effective in maintaining corneal endothelial viability without compromising the surgical experience and post-operative visual outcome.  Keywords: 1% Ultrasound power, Coefficient of variation, Endothelial cell density, Percentage hexagonal cells, Phacoemulsification.

Assessment of corneal endothelial status post phacoemulsification with 1% ultrasound power in hard cataracts