Endothelial Cell Loss after Phacoemulsification according to Different Anterior Chamber Depths.

Hyung Bin Hwang,Hye Bin Yim,Byul Lyu,Na Young Lee

doi:10.1155/2015/210716

Hyung Bin Hwang, Hye Bin Yim + Show 2 more

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https://doi.org/10.1155/2015/210716

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Abstract

Purpose. To compare the loss of corneal endothelial cells after phacoemulsification according to different anterior chamber depths (ACDs). Methods. We conducted a prospective study on 135 eyes 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 mean cumulative dissipated energy (CDE) was measured. Clinical examinations included central corneal thickness (CCT) and endothelial cell count (ECC) preoperatively and 2 months postoperatively. Results. There were no significant differences in CDE among the ACD groups (P > 0.05). Endothelial cell loss was significantly higher in ACD I than in ACD III in grades 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. Conclusions. Eyes with shallow ACDs, especially those with relatively hard cataract densities, can be vulnerable to more corneal endothelial cell loss in phacoemulsification surgery.

Highlights

Corneal endothelial cells are nonreplicative, and the loss of these cells is only compensated for by the migration, enlargement, and increasing heterogeneity of the cells [1]
In analysis of covariance (ANCOVA), setting covariates of age, ultrasound time (UST), cumulative dissipated energy (CDE), and balanced salt solution (BSS) use, the mean percentage of endothelial cell loss was significantly different among the three anterior chamber depths (ACDs) groups in the NO3 and NO4 subgroups (P < 0.05)
It is inevitable that endothelial cell damage will occur during the phacoemulsification procedure

Summary

Introduction

Corneal endothelial cells are nonreplicative, and the loss of these cells is only compensated for by the migration, enlargement, and increasing heterogeneity of the cells [1]. The evaluation of risk factors for preoperative, intraoperative, and postoperative endothelial cell loss provides important information for the cataract surgeon. Some studies have demonstrated that ACD did not affect endothelial cell loss after phacoemulsification surgery using a statistical correlation method [6, 7]. These studies did not give careful consideration to other surgical factors, such as cumulative dissipated energy (CDE), ultrasound time (UST), and balanced salt solution (BSS) use as confounding factors. To the best of our knowledge, no stratified controlled study has compared endothelial cell damage according to different ACDs, controlling for confounding factors such as age, cataract nucleus density, CDE, UST, and BSS use. We compared corneal endothelial cell loss according to different ACDs in patients with various cataract nucleus densities

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