Cataract surgery in eyes with low corneal endothelial cell density
ABSTRACT To compare corneal endothelial damage after cataract surgery in eyes with low endothelial cell density (ECD) and eyes with normal ECD.
Hayashi Eye Hospital, Fukuoka, Japan.
Cataract surgery was performed in eyes with a low ECD (500 to 1000 cells/mm(2)) (low-density group) and control eyes with a normal ECD. The ECD and central corneal thickness (CCT) were measured preoperatively and 1 and 3 months postoperatively, and the percentage cell loss and increase in CCT were compared.
The low-density group and control group each comprised 50 eyes. In the low-density group, 39 eyes had nonprogressive endothelial pathology and 11 had Fuchs dystrophy. The mean ECD was significantly less and the CCT significantly greater in the low-density group than in the control group throughout the follow-up (P ≤.0066). However, no significant difference in the percentage of cell loss was found between groups at 1 or 3 months (5.1%, low-density group; 4.2%, control group) (P ≥.1477). The percentage increase in CCT was significantly greater in the low-density group than in the control group at 1 month (P<.0001), although there was no significant difference at 3 months (0.4% and -0.4%, respectively) (P=.2172).
Corneal endothelial damage after cataract surgery in eyes with low ECD was slight and comparable to that in healthy eyes, which suggests that cataract surgery alone (without corneal transplantation) should be performed first.
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ABSTRACT: Cataract affects more than 20 million people worldwide and is the leading cause of vision loss. Currently, the phacoemulsification is the most used procedure to extract cataract and recover visual acuity. Optimal phacoemulsification energy is demanded for safety cataract removal. It is well established that the energy value is determined by the cataract hardness. In this study twenty porcine eyes were used as experimental samples. Cataract was induced by an ethanol:2-propanol:formalin solution. A 25 MHz focused transducer has been used to estimate the ultrasound velocity and attenuation. Statistical analysis was performed to compare the different used methodologies and to correlate the different ultrasound parameters with different stages of cataract formation (lens hardness).IEEE International Ultrasonics Symposium (IUS), Dresden, Germany; 10/2012
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ABSTRACT: AIM: To compare and evaluate the phacoemulsification parameters and postoperative endothelial cell changes of two different phacoemulsification machines, each with different modes, but also to assess the relationship between postoperative endothelial cell loss and the phacoemulsification parameters, as well as the other factors in both groups. METHODS: This prospective observational study was comprised of consecutive eligible cataract patients operated with phacoemulsification technique performed by the same surgeon using either a WHITESTAR Signature Ellips FX (transversal, group 1) or Infiniti OZil IP (torsional, group 2) machine. RESULTS: The study included 86 patients. Baseline characteristics in the groups were similar. The median nuclear sclerosis grade was 3 (2-4) in the first group and 2 (2-4) in the second group (P=0.265). Both groups had similar phacoemulsification needle times (group 1: 60.63 +/- 36 s; group 2: 55.98 +/- 30 s; P=0.789). The percentage of endothelial cell loss 30d after surgery ranged from 3% to 15% with a median of 7% in group 1, and from 2% to 13% with a median of 6% in group 2; however, there was no statistically significant difference between the,groups (P=0.407). Hexagonality (P=0.794) and the coefficient of variation (CV; P =0.142) did not differ significantly between the groups before and 30d after surgery. A significant positive correlation was found between the endothelial cell loss and nuclear sclerosis grade (group 1: P <0.001; group 2: P <0.001) and between the endothelial cell loss and average phacoemulsification power (group 1: P =0.007; group 2: P=0.008). CONCLUSION: Both of these machines were efficient, with similar endothelial cell loss. This endothelial cell loss was related to the increased nuclear sclerosis grade and increased phacoemulsification power.International Journal of Ophthalmology 10/2014; 7(5):822-7. DOI:10.3980/j.issn.2222-3959.2014.05.15 · 0.12 Impact Factor
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ABSTRACT: To compare the RTVue spectral optical coherence tomography (SD-OCT), Sirius Scheimpflug-Placido topographer, Lenstar optical low coherence reflectometry (OLCR) and ultrasound pachymetry (USP) devices in terms of their agreement and repeatability of measuring central corneal thickness (CCT). In this prospective study, 50 eyes of 50 patients were included. Three repeated measures were obtained using SD-OCT, Scheimpflug-Placido topographer and USP and five measurements were determined with the OLCR. Bland-Altman plots were used to assess agreement among the instruments, and 95% limits of agreement (LoA) for each comparison were calculated. Intra-examiner repeatability was assessed using intraclass correlation coefficients (ICCs). The mean CCT by SD-OCT, Scheimpflug-Placido topographer, OLCR, and USP were 525.90±34.08 µm, 525.92±34.10 µm, 530.30±35.62 µm, and 543.50±37.11 µm respectively. All 4 modalities of CCT measurements correlated closely with each other, with Pearson correlation coefficients ranging from 0.977 to 0.995. The mean differences (and upper/lower LoA) for CCT measurements were -0.05±6.77 µm (13.3/-13.3) between SD-OCT and Scheimpflug-Placido topographer, 4.38±3.79 µm (11.8/-3.1) between OLCR and SD-OCT, 4.38±6.03 µm (16.2/-7.5) between OLCR and Scheimpflug-Placido topographer, 13.20±6.46 µm (25.9/0.5) between USP and OLCR, 17.59±6.76 µm (30.8/4.3) between USP and SD-OCT, and 17.58±8.13 µm (33.5/1.6) between USP and Scheimpflug-Placido topographer. Intra-examiner repeatability was excellent for all devices with ICCs>0.98. For most practical purposes, CCT measurements with the RTVue, Sirius and Lenstar can be used interchangeably. Although highly correlated, CCT measurement differences between USP and these 3 optical instruments can be significant depending on the clinical situation.International Journal of Ophthalmology 04/2014; 7(2):302-308. DOI:10.3980/j.issn.2222-3959.2014.02.19 · 0.50 Impact Factor