Abstract
Background:The corneal endothelium has no ability of regeneration, so any decrease in its density is irreversible and can lead to permanent blurring of vision and pain. Direct contact between air and the corneal endothelium may cause endothelial damage. Aim:To compare the effect of reformation of the anterior chamber after phacoemulsification, using air and ringer’s lactate solution injection, on corneal endothelial count and morphology. Subject and method:A prospective interventional randomized comparative study includes 76 eyes of 76 patients, prepared for phacoemulsification surgery in the period from October 2018 to March 2019. Corneal endothelial morphology and count examined by specular microscopy, and the results recorded for all cases before the surgery. Patients examined by slit lamp biomicroscope and divided randomly into two groups, and both groups were diagnosed with grade 1-2 age related nuclear cataract (according to Lens opacity classification system III). Both groups underwent phacoemulsification surgery with IOL implantation by single well-trained surgeon, group 1 will be subjected to anterior chamber reformation with 0.1 ml air injection while group 2 will be subjected to reformation of the anterior chamber with ringer’s lactate solution. Corneal endothelial morphology and count to be evaluated at 1 week, 1 month and 3 months postoperatively. Results:no significant statistical difference regarding the percentage of CCT changes, cell loss, coefficient of variation and hexagonality between the two groups at baseline and all subsequent visits. Conclusion:no significant difference between air and ringer's lactate solution on the corneal endothelial count and morphology.
Highlights
Cataract is the leading cause of vision loss in the world
Both groups underwent phacoemulsification surgery with intraocular lens (IOL) implantation by single well-trained surgeon, group 1 will be subjected to anterior chamber reformation with 0.1 ml air injection while group 2 will be subjected to reformation of the anterior chamber with ringer’s lactate solution
The cumulative dissipated energy was recorded for all cases during the phacoemulsification; the mean CDE in-group 1 was 23.5 ±7.3, while the mean CDE in group 2 was 25.2 ±9.1
Summary
Cataract is the leading cause of vision loss in the world. The world health organization (WHO) has estimated 18 million people are bilaterally blind due to cataract and the condition causes 48% of blindness worldwide[1].Phacoemulsification is the standard method of cataract extraction in developed countries, and in regional centers in most developing countries 2. Cataract is the leading cause of vision loss in the world. The world health organization (WHO) has estimated 18 million people are bilaterally blind due to cataract and the condition causes 48% of blindness worldwide[1]. Phacoemulsification is the standard method of cataract extraction in developed countries, and in regional centers in most developing countries 2. Phacoemulsification surgery has a deleterious effect on corneal endothelial cell count, the severity of cell loss depends on many variables, such as phacoemulsification time and energy, surgical technique, anterior chamber depth, and the use of ophthalmic viscoelastic devices 3. The cornea acts as a clear refractive surface and a protection barrier to infection and trauma.
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