The Change in Corneal Endothelial Cell Density after Pars Plana Vitrectomy

Lee, Ja Young; Rhee, Mi Ri; Choi, Kyung Seek; Lee, Sung Jin

Abstract

PURPOSE
To assess the effect of pars plana vitrectomy and gas tamponade on corneal endothelial cell density.
METHODS
The corneal endothelial cell density in 145 eyes that underwent pars plana vitrectomy was examined with a noncontact specular microscope 3 months pre- and post-operation. The subjects were divided as follows: Group 1 (32 eyes) underwent pars plana vitrectomy, group 2 (26 eyes) underwent pars plana vitrectomy combined with gas tamponade, group 3 (34 eyes) underwent pars plana vitrectomy combined with phacoemulsification and group 4 (48 eyes) underwent pars plana vitrectomy combined with phacoemulsification and gas tamponade. The changes in corneal endothelial cell density between groups was compared.
RESULTS
The mean endothelial cell loss was more significant in group 2 than in group 1 (p = 0.012), and there was no difference between groups 3 and 4 (p = 0.063). However, after excluding 6 eyes that had blood in the center of the corneal endothelium as a result of being in the prone position following gas tamponade, the mean endothelial cell loss in group 2 was not less than in group 1. In eyes with blood in the corneal endothelium, endothelial cell loss significantly increased (p < 0.001).
CONCLUSIONS
The results of this study suggest that ophthalmic surgeons should attempt to carefully control bleeding and sufficiently irrigate the vitreous during pars plana vitrectomy combined with gas tamponade.