J Korean Ophthalmol Soc.  2017 Feb;58(2):131-139. 10.3341/jkos.2017.58.2.131.

Influence of Preoperative Corneal Endothelial Status on Postoperative Corneal Endothelium Density after Cataract Surgery

• Kim P
• Jung MS

• KMID: 2369459
• DOI: http://doi.org/10.3341/jkos.2017.58.2.131

Abstract

PURPOSE
To analyze the influence of preoperative corneal endothelial status on postoperative corneal endothelium density after cataract surgery.
METHODS
We evaluated 228 eyes of 158 patients who underwent cataract surgery. Corneal endothelial status and central corneal thickness were measured before surgery and 1 day, 1 month, 3 months and 6 months after surgery. Patients were classified by preoperative endothelial cell density (three groups) and their coefficients of variation and hexagonality (two groups). Clinical parameters, including corneal endothelial cell losses, visual acuity, intraocular pressure, spherical equivalent refraction and central corneal thickness were measured to compare the intergroup indices.
RESULTS
There were no significant differences in corneal endothelial cell losses at 1 day, 1 month, 3 months and 6 months after surgery in any of the groups based on corneal endothelial cell density. There were increases in corneal thickness at 1 day and 1 month after surgery that were significantly higher in the low-endothelial cell density group than the 2,000-2,500 cells/mm² cell density group (p < 0.05), but there were no differences after the 3-month time point. There were no significant differences in clinical parameters for the coefficient of variation and hexagonality groups until 6 months after surgery.
CONCLUSIONS
We observed reversible corneal edema in the low endothelial group; however, there were no significant intergroup differences in corneal endothelial cell loss due to preoperative corneal endothelial status. Our results suggest that cataract surgery is relatively safe for patients with morphologically abnormal corneal endothelium and/or low endothelial density; the safety is primarily due to improved equipment and surgery techniques.

Keyword

Coefficient of variation; Endothelial cell loss; Hexagonality; Phacoemulsification

MeSH Terms

Cataract*
Cell Count
Corneal Edema
Corneal Endothelial Cell Loss
Endothelial Cells
Endothelium, Corneal*
Humans
Intraocular Pressure
Phacoemulsification
Visual Acuity

Figure

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  Figure 1. Comparison of different clinical parameters within subject groups with different cell density. Comparison of best corrected visual acuity (A), spherical equivalent refraction (B), intraocular pressure (C), central corneal thickness (D) and en-dothelial cell loss (E) in subject groups with different cell density. There were no statistically significant differences among the three groups, except in central corneal thickness of 1 day and 1 month after surgery. ECD = endothelial cell den-sity; Pre op = preoperation. * Statistically difference between the ECD < 2,000 cells/mm2 and 2,000-2,500 cells/mm2.

• 

  Figure 2. Comparison of different clinical parameters within subject groups with different coefficient of variation. Comparison of best corrected visual acuity (A), spherical equivalent re-fraction (B), intraocular pressure (C), central corneal thickness (D) and endothelial cell loss (E) in subject groups with different coefficient of variation. There were no statistically significant differences between the two groups. Pre op = preoperation; CV = coefficient of variation.

• 

  Figure 3. Comparison of different clinical parameters within subject groups with different hexagonality. Comparison of best corrected visual acuity (A), spherical equivalent refraction (B), intraocular pressure (C), central corneal thickness (D) and endo-thelial cell loss (E) in subject groups with different hexagonality. There were no statistically significant differences between the two groups. Pre op = preoperation; HEX = hexagonality.

Reference

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