Korean J Ophthalmol.  2010 Oct;24(5):284-290. 10.3341/kjo.2010.24.5.284.

Anterior Segment Parameters Using Pentacam and Prediction of Corneal Endothelial Cell Loss after Cataract Surgery

• Cho YK
• Chang HS
• La TY
• Ji D
• Kim H
• Choi JA
• Kim MS

• KMID: 974322
• DOI: http://doi.org/10.3341/kjo.2010.24.5.284

Abstract

PURPOSE
We evaluated various preoperative anterior segment parameters measured with a Pentacam rotating Scheimpflug camera and compared them with those of conventional methods. We also evaluated the effect of different parameters on corneal endothelial cells after cataract surgery.
METHODS
Pentacam examination was performed in 88 eyes from 88 patients to evaluate central anterior chamber depth (ACD(pentacam)), nuclear density (Densitometry(pentacam)), anterior chamber volume (ACV), and lens thickness (LT(pentacam)). We compared values of ACD(pentacam) with those of ultrasound (ACD(sono)) and also compared Densitometry(pentacam) values with those of Lens Opacities Classification System (LOCS III) classification. We evaluated the effect of the following preoperative values measured with Pentacam on postoperative endothelial cell loss: pupil size measured both preoperatively and before capsulorrhexsis (Pupil(CCC)), amount of viscoelastics, and LT measured by ultrasound (LT(sono)).
RESULTS
A significant concordance was found between the two grading methods of nuclear opacity: Densitometry(pentacam) and LOCS III classification (tau(b) = 0.414, p = 0.000). We also found a positive correlation between ACD(pentacam) and ACD(sono) (r = 0.823, p = 0.000) and between ACD(pentacam) and ACV (r = 0.650, p = 0.000). There were significant differences between the results of LT(pentacam) and LT(sono). The final regression model identified Densitometry(pentacam), viscoelastics and Pupil(CCC) as independent predictors of decreased postoperative corneal endothelial cell density (CD) at postoperative day 3, and Densitometry(pentacam), viscoelastics, and ACV as independent predictors of decreased CD two months postoperatively (p<0.05).
CONCLUSIONS
Good agreement was found between all results obtained with the Pentacam and conventional methods except LT. Analyzing anterior chamber parameters preoperatively using Pentacam could be helpful to predict postoperative endothelial cell loss.

Keyword

Anterior segment parameters; Corneal endothelium; Pentacam

MeSH Terms

Adult
Aged
Aged, 80 and over
Anterior Chamber/*pathology/ultrasonography
Cataract/classification
Cataract Extraction/*methods
Corneal Endothelial Cell Loss/*diagnosis
Female
Humans
Linear Models
Male
Middle Aged
Photography/*instrumentation
Predictive Value of Tests

Figure

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  Fig. 1 Measurement of pupil size a measured before capsulorrhexis (PupilCCC). PupilCCC was measured before capsulorrhexis using a blunt-ended, viscoelastics injection needle of known length.

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  Fig. 2 Correlation of anterior chamber depth (mm) by Pentacam (ACDpentacam) and ultrasound (ACDsono) (r = 0.822, p < 0.05).

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  Fig. 3 Correlation between anterior chamber depth (ACD) measured by Pentacam (ACDpentacam) and anterior chamber volume (ACV) (r = 0.650, p = 0.000).

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  Fig. 4 Correlation between anterior chamber volume (ACV) and injected amount of viscoelastics before capsulorrhexis (r = -0.021, p = 0.850).

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  Fig. 5 Correlation between anterior chamber depth by Pentacam (ACDpentacam) and injected amount of viscoelastics before capsulorrhexis (r = 0.123, p = 0.253).

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