Effect of Reformation of the Anterior Chamber by Air or by a Balanced Salt Solution (BSS) on Corneal Endothelium after Phacoemulsification: A Comparative Study.

Alahmady Hamad Alsmman,Osama Ali Mohammed,Ahmed Mohamed Sherif,Mahmoud Farouk,Ashraf Mostafa Elhawary,Mohammed Ezzeldawla,Amr Mounir

doi:10.1155/2018/6390706

Alahmady Hamad Alsmman, Osama Ali Mohammed + Show 5 more

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https://doi.org/10.1155/2018/6390706

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Journal: Journal of Ophthalmology	Publication Date: Jan 1, 2018
Citations: 5	License type: CC BY 4.0

Affiliation: Sohag University, Cairo University

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Aim To study the effect of reformation of the anterior chamber by air or by a balanced salt solution, after smooth phacoemulsification on the corneal endothelial count and morphology. Methods A prospective interventional nonrandomized comparative study included 500 eyes of 500 patients with age range between 50 and 60 years, prepared for cataract surgery and presented to the Ophthalmology department of Sohag University Hospital in the period from October 2016 to May 2017. Corneal endothelial morphology and count were examined, and the results were recorded for all cases before the surgery. Patients were divided into two groups, and both groups were diagnosed with grade 2 cataract and underwent uncomplicated phacoemulsification performed by well-trained surgeons. At the end of the surgery, group 1 was subjected to a reformation of the anterior chamber via a balanced salt solution (BSS) injection while group 2 was subjected to a reformation of the anterior chamber via air injection. Corneal endothelial morphology and count were evaluated in the first and 3rd month postoperatively. Results The study included 500 patients (250 in each group), 220 males (44%) and 280 females (56%) with no significant statistical age differences. Both preoperative and postoperative (3 months after the operation) recorded parameters of the corneal endothelium did not show any significant statistical differences. The cumulative dissipated energy was recorded, for all cases of both groups, during phacoemulsification with no significant statistical differences (P = 0.7). Conclusion There is no difference between the effect of reformation of the anterior chamber after phacoemulsification, using air or using a BSS injection, on the corneal endothelial count and morphology.

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Cataract surgery is one of the most frequently performed surgeries worldwide
This study aims at comparing the effect of reformation of the anterior chamber after phacoemulsification, using air and balanced salt solution (BSS) injection, on corneal endothelial count and morphology
No significant statistical differences were recorded in the preoperative data about the age and the corneal parameters which include endothelial cell density, the coefficient of variance, hexagonality, and central corneal thickness (Table 1)

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It is well established that this surgery has a negative effect on corneal endothelium, as it decreases the endothelial cell count. The corneal endothelium functions as an active pump and as a barrier against the aqueous humor of the anterior chamber; it holds an important role in the process. Journal of Ophthalmology of corneal tissue hydration. It has no ability of regeneration, so any decrease in its density is irreversible and can lead to permanent blurring of vision and pain [2]. The corneal injury caused by phacoemulsification usually leads to corneal edema, and if it is severe enough, it might result in irreversible bullous keratopathy, making corneal tissue transplantation the only effective treatment [2]

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