Evaluation of corneal endothelial cell damage after vitreoretinal surgery: comparison of different endotamponades.

Abstract

We evaluated corneal endothelial cell (EC) damage after vitreoretinal surgery and compared the results using different tamponades. This prospective controlled study included 45 eyes of 45 patients (24 females, 21 males) who underwent pars plana vitrectomy with gas (sulphur hexafluoride, SF6, 20%) or silicone oil (SO) tamponade. Patients were assigned to one of the three groups: group 1 (phakic, 20% SF6 gas), group 2 (pseudophakic, 20% SF6 gas), and group 3 (phakic, SO). Mean endothelial cell density (MCD), mean cell area (MCA), coefficient of variation in cell size (CV), and percentage of hexagonal cells (HC) values were measured using a non-contact specular microscope (SP-2000P; Topcon, Japan) at baseline and at 3 months after surgery. The fellow eye of each patient was used as a control. Group 2, which had the lowest baseline MCD and MCA values, was found to be different than groups 1 and 3 (P=0.028 and 0.022, respectively). At 3 months postoperatively, all groups showed significantly lower MCD, HC and CV values than at baseline (all P<0.05). The mean changes in MCD at 3 months after surgery were 3.8±2.8% (mean±SD), 8.0±7.5%, and 4.6±5.4% in groups 1-3, respectively. The mean MCD changes in the fellow eyes were 0.31±1.41% in group 1, -0.63±1.90% in group 2, and 0.14±0.52 in group 3 at 3 months postoperatively (P>0.05 for all). Our findings revealed that corneal EC damage may occur after vitreoretinal surgery with gas or SO tamponade. Eyes that had undergone previous cataract surgery were more vulnerable to EC loss than phakic eyes, supporting the protective effect of an intact lens.