Endothelial cell loss after phacoemulsification according to different anterior chamber depths measured by IOL master

Abstract

PurposeTo compare the loss of corneal endothelial cells after phacoemulsification according to different anterior chamber depths (ACDs), as measured with the IOL Master.MethodsWe conducted a prospective, randomized clinical study on 135 eyes of 135 patients with senile cataracts. Eyes with nuclear density grades of 2 to 4 were divided into three groups according to ACD: ACD I, 1.5 < ACD < 2.5 mm; ACD II, 2.5 < ACD < 3.5 mm; or ACD III, 3.5 < ACD < 4.5 mm. Intraoperative ultrasound time (UST), mean cumulative dissipated energy (CDE), and balanced salt solution (BSS) use were measured. Clinical examinations included central corneal thickness (CCT), endothelial cell count (ECC), and corrected distance visual acuity (CDVA) preoperatively, and 1 day, 1 month, and 2 months postoperatively.ResultsThere were no significant differences in CDE among the ACD groups (P > 0.05). The percentage of endothelial cell loss was significantly higher in ACD I than ACD III in the grade 3 and 4 cataract density groups 2 months after phacoemulsification (P < 0.05). There were also more changes in CCT in all of the cataract density groups in the ACD I group compared to the ACD II and III groups 2 months postoperatively, but the difference was not statistically significant.ConclusionsEyes with shallow ACDs, especially those with relatively hard cataract densities, can be vulnerable to more corneal endothelial cell loss in phacoemulsification surgery. Thus, more attention is needed to avoid corneal decompensation in cataract surgery on patients with shallow ACDs and hard nucleus densities.