الفهرس 
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Abstract
This prospective, interventional study with randomly selected patients was carried out at Zagazig ophthalmic hospital outpatient that undergo phacoemulsification and posterior chamber foldable intraocular lens implantation.
The aim of this study was to compare the loss of corneal endothelial cells after phacoemulsification according to different ACDs in hard cataract and asses the differences in CDE, U/S time and irrigation solution volume used as confounding factors during the surgery.
In this study 30 eyes of 25 non diabetic patients with nuclear opalescence grade 3 were divided into 2 groups according to anterior chamber depth of group A > 2.99 mm & group B < OR = 2.99 mm.
The corrected distance visual acuity and endothelial cell count were calculated and compared for each group preoperative, 1 week and 2 months postoperative.
In all surgeries the total solution volume used, U/T time and MCDE were calculated and compared between the 2 groups.
The study results showed that the age of the group B was statistically significant higher than that of group A but there was no statistical significant difference between the 2 groups regarding sex and affected side.
The mean endothelial cell count of group A (2615 cells/mm2) was statistically significant higher than that of group B (2292 cells/mm2) and the preoperative CDVA was also statistically significant better in group A than in group B.
The intra-operative U/S time, MCDE and irrigation solution volume were all higher in group B than in group A without statistically significant difference.
In each group the preoperative ECC was statistically highly significant higher than the ECC at 1 week and 2 months postoperative and the endothelial cell loss was statistically significant higher in group B than in group A and in both groups the endothelial cell loss was statistically significant more at 2 months than 1 week postoperative.
The endothelial cell count of group A became statistically highly significant higher than the ECC of group B at 1 week and 2 months postoperative.
In each group there was statistically highly significant improvement in CDVA at 1 week and 2 months postoperative and was statistically significant better in group A than in group B one week postoperative and statistically significant better in group A than in group B 2 months postoperative.
According to the up mentioned results the current study concluded that shallow ACD is a risk factor for endothelial cell loss after phaco cataract surgery of hard cataract (NO3). So, surgeons should pay more care in patient with shallow ACD with hard cataract densities.
The current study limitation was the small sample size (30 eyes of 25 patients), short follow up duration period and use A-scan US that may be less reliable in measuring ACD than optical pachymetry. So, further studies with more enrolled patients, longer follow up duration period and use of optical pachymetry in measuring ACD should be done.