Corneal endothelial cell .loss after manual small incision cataract surgery and phacoemulsification at Muhimbili National Hospital, Dar es salaam.

Background: Cataract is the world’s leading cause of blindness with around 20 million people bilaterally blind due to cataract1. The definitive treatment of cataract is surgical removal of the opacified lens which is aimed at restoring normal vision 3, 5. However, every cataract extraction even in experienced hands is associated with some endothelial cell damage. Endothelial cell loss if sufficiently severe can cause endothelial cell density to fall below the threshold level needed to maintain corneal transparency. This can lead to the development of late corneal decompensation which ultimately leads to poor visual outcome which has been reported to occur in about 1% of cataract extractions 7, 11, 27, 28, 29. Broad objective: To assess the corneal endothelial cell loss after manual small incision cataract surgery and phacoemulsification at Muhimbili National Hospital, Dar es Salaam. Methodology: A hospital based descriptive, prospective cohort study was conducted between April 2012 and January 2013. A total of 127adult patients with 131eyes who underwent cataract surgery at MNH were enrolled. Patients were examined whereby demographic data, pre and post operative corneal endothelial cell count as well as post operative visual acuity were recorded. Corneal endothelial cell count was determined by use of a TOPCON SP.2000P specular microscope. Results: All 131 eyes assessed by specular microscope had preoperative corneal endothelial cell count ranging from 1500 – 3000 cells/mm2 which decreased with increasing age (P