ButThe modern standard of cataract surgery is phacoemulsification with implantation in the bag. Phacoemulsification and implantation of a foldable IOL are currently possible without viscoelastics. The aim of the study is to investigate surgery without viscoelastics regarding complications and endothelial cell loss.Objectifs et MéthodesIn a prospective, randomised and masked study 126 patients were enrolled. Parameters studied were surgery safety, preoperative and postoperative IOP, corneal endothelial cell changes with and without viscoelastics.RésultatsIn the BSS group at one months postoperatively a mean endothelcell loss of 106-226 cells/mm²(corresponding 4.5%) and in the Healon group of 122-207 cells/mm²(corresponding to a loss of 5.3%) were find out.DiscussionData analysis showed no significant difference between the groups. Likewise no significant difference was seen regarding cell size, cell shape and IOP pre- and postoperatively. A significant correlation was observed between patient age and endothelial cell loss.ConclusionThe phacoemulsification technique can be performed with viscoelastics or without, under continous AC irrigation, with the same level of safety regarding endothelial cell damage.