Risk factors for endothelial cell loss after phacoemulsification: comparison in different anterior chamber depth groups

Yang Kyeung Cho, Hwa Seok Chang, Man Soo Kim, Yang Kyeung Cho, Hwa Seok Chang, Man Soo Kim

Abstract

Purpose: To assess the risk factors for endothelial cell loss after phacoemulsification with implantation of intraocular lens according to anterior chamber depth (ACD).

Methods: This prospective study included 94 eyes of 94 patients undergoing phacoemulsification cataract surgery. To assess the risk factors for corneal endothelial cell loss, we examined seven variables at 1 day, 1 week, 6 weeks, and 12 weeks postoperatively in each ACD-stratified group.

Results: Multiple linear regression analysis showed that the only variable influencing the percentage decrease in corneal endothelial cell density throughout the postoperative follow-up period in the long ACD group (ACD III) was nucleosclerosis. The variables influencing the percentage decrease in corneal endothelial cell density in the short ACD group (ACD I) at one day and one week postoperatively were corneal incisional tunnel length and nucleosclerosis.

Conclusions: Risk factors for endothelial cell loss after phaoemulsification were different according to ACD. Long corneal tunnel length can be one of the risk factors for endothelial cell loss in short ACD eyes.

Keywords: Endothelial cell density; Phacoemulsification; Tunnel length.

Figures

Fig. 1
Fig. 1
Corneal incisional tunnel length (A) and corneal incision length (B).

References

    1. Mencucci R, Ponchietti C, Virgili G, et al. Corneal endothelial damage after cataract surgery: microincision versus standard technique. J Cataract Refract Surg. 2006;32:1351–1354.
    1. O'Brien PD, Fitzpatrick P, Kilmartin DJ, Beatty S. Risk factors for endothelial cell loss after phacoemulsification surgery by a junior resident. J Cataract Refract Surg. 2004;30:839–843.
    1. Hayashi K, Hayashi H, Nakao F, Hayashi F. Risk factors for corneal endothelial injury during phacoemulsification. J Cataract Refract Surg. 1996;22:1079–1084.
    1. Pereira ACA, Porfirio F, Freitas LL, Belfort R., Jr Ultrasound energy and endothelial cell loss with stop-and-chop and nuclear preslice phacoemulsification. J Cataract Refract Surg. 2006;32:1661–1666.
    1. Dosso AA, Cottet L, Burgener D, Di Nardo S. Outcomes of coaxial microincision cataract surgery versus conventional coaxial cataract surgery. J Cataract Refract Surg. 2008;34:284–288.
    1. Storr-Paulsen A, Norregaard JC, Ahmed S, et al. Endothelial cell damage after cataract surgery: divide- and conquer versus phaco-chop technique. J Cataract Refract Surg. 2008;34:996–1000.
    1. Walkow T, Anders N, Klebe S. Endothelial cell loss after phacoemulsification: relation to preoperative and intraoperative parameters. J Cataract Refract Surg. 2000;26:727–732.
    1. Steinert RF. Cataract surgery: technique, complication and management. 2nd ed. Philadelphia, PA: WB Saunders; 2004. pp. 357–358.
    1. Buratto L, Buratto L, Buratto C. In: Cataract surgery in complicated cases. Buratto L, Osher R, Masket S, editors. Thorofare, NJ: SLACK; 2000. chap. 6.
    1. Fine IH, Hoffmann RS. In: Cataract surgery in complicated cases. Buratto L, Osher R, Masket S, editors. Thorofare, NJ: SLACK; 2000. chap. 7.
    1. Ernest PH, Lavery KT, Kiessling LA. Relative strength of sclera corneal and clear corneal incisions constructed in cadaver eyes. J Cataract Refract Surg. 1994;20:626–629.
    1. Beltrame G, Salvetat ML, Driussi G, Chizzolini M. Effect of incision size and site on corneal endothelial changes in cataract surgery. J Cataract Refract Surg. 2002;28:118–125.
    1. Lundberg B, Jonsson M, Behndig A. Postoperative corneal swelling correlates strongly to corneal endothelial cell loss after phacoemulsification cataract surgery. Am J Ophthalmol. 2005;139:1035–1041.
    1. Agarwal A, Kumar DA, Jacib S, Agarwal A. In vivo analysis of wound architecture in 700 µm microphaconit cataract surgery. J Cataract Refract Surg. 2008;34:1554–1560.
    1. May W, Castro-Combs J, Camacho W, et al. Analysis of clear corneal incision integrity in an ex vivo model. J Cataract Refract Surg. 2008;34:1013–1018.

Source: PubMed

Sponsorer og samarbejdspartnere

Medicinske tilstande

Narkotikainterventioner

3
Abonner