Abstract
In phacovitrectomy the cataract is usually operated on first including implantation of the intraocular lens (IOL) before beginning vitrectomy but the IOL can also be implanted following vitrectomy. This variation avoids optical impairments from corneal opacities and the lens rim, improves the visualization of the retina during surgery and might thereby reduce intraoperative complications, such as peripheral retinal tears or IOL subluxation. It might, however, increase stress on the corneal endothelium. The aim of this study was, therefore, to compare postoperative corneal endothelial cell loss for the standard procedure of phacovitrectomy and the surgical variation. In this retrospective study 41eyes were each assigned to groupI (standard phacovitrectomy) or groupII (variation of phacovitrectomy). The primary endpoint was the absolute and relative corneal endothelial cell loss appearing 5 ± 1weeks postoperatively with reference to the preoperative number of endothelial cells. Secondary endpoints included visual acuity, intraocular pressure, coefficient of variation of endothelial cell area (CV), proportion of hexagonal endothelial cell forms (6A), pachymetry, intraoperative and postoperative complications. The absolute and relative endothelial cell loss in groupI (-108 ± 146; -4.1 ± 5.7%) did not differ significantly from that in groupII (-73 ± 122; -3.1 ± 5.3%, p = 0.299; p = 0.388). The secondary endpoints also showed no significant differences. The presented variation of phacovitrectomy expands the surgical options and does not show asignificantly different postoperative corneal endothelial cell loss compared to the standard procedure.
Highlights
Background and purposeIn phacovitrectomy the cataract is usually operated on first including implantation of the intraocular lens (IOL) before beginning vitrectomy but the IOL can be implanted following vitrectomy
each assigned to group I (standard phacovitrectomy
significantly different postoperative corneal endothelial cell loss compared to the standard procedure
Summary
Anastasia Seifert1,2,6 · Berthold Seitz3 · Gudrun Wagenpfeil4 · Klaus Ludwig1,2,5 · Matthias Krause. Die Autoren Klaus Ludwig und Matthias Krause haben zu gleichen Teilen zu der Arbeit beigetragen. Man kann die Kunstlinse aber auch erst am Ende der Vitrektomie in den Kapselsack implantieren. Da diese Variante aber das Hornhautendothel zusätzlich belasten könnte, war das Ziel der vorliegenden Studie, den postoperativen Endothelzellverlust nach Standardphakovitrektomie mit dem nach der alternativen Variante zu vergleichen. Zu den sekundären Zielgrößen gehörten Sehschärfe, Augeninnendruck, Variationskoeffizient der Zellfläche des Endothels (CV), Anteil der hexagonalen Zellform des Endothels (6A), Pachymetrie, intra- und postoperative Komplikationen. Ergebnisse: Der absolute und der relative Endothelzellverlust in Gruppe I Schlussfolgerungen: Die hier vorgestellte Variante der Phakovitrektomie erweitert die chirurgischen Optionen und zeigt im Vergleich zum Standardverfahren keinen signifikant abweichenden postoperativen kornealen Endothelzellverlust. Schlüsselwörter Phakovitrektomie · Endothelzellverlust · Variationskoeffizient der Zellfläche (CV) · Anteil der hexagonalen Zellen (6A%) · Pachymetrie
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