Corneal endothelial cells, by keeping the corneal stroma in a deturgescent state, play the main role in maintaining corneal clarity. Intraocular surgeries are known to cause endothelial damage. This is particularly important in case of phacoemulsification cataract surgery. The endothelial damage may be due to a direct mechanical effect of the ultrasonic waves or perhaps due to the production of free radicals during an operation.

This study is a non-randomized interventional study performed on 92 eyes of 85 patients, operated on in the Khatam al Anbia Eye Hospital. Biometry, Specular microscopy, and pachymerty in addition to complete ophthalmologic examination were done for all patients before and after standard phacoemulsification surgery with a temporal limbal incision.

Endothelial cells decreased after surgery in 14.46% of the patients, which was statistically significant (P=0.04). There was statistically increased thickening of the central cornea (P=0.02). Endothelial cell loss was more prominent among diabetic patients (P=0.002).

Phacoemulsification could result in a significant corneal endothelial damage. This is particularly important in case of patients with a borderline reservoir of endothelial cells. Refining current surgical methods and instruments to minimize endothelial damage is recommended.