The Change in Corneal Endothelial Cell Density after Pars Plana Vitrectomy

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

doi:10.3341/jkos.2011.52.5.544

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Lee, Rhee, Choi, and Lee: The Change in Corneal Endothelial Cell Density after Pars Plana Vitrectomy

Original Article

J Korean Ophthalmol Soc 2011;52(5):544-549.

Published online: 3 August 2011

DOI: https://doi.org/10.3341/jkos.2011.52.5.544

The Change in Corneal Endothelial Cell Density after Pars Plana Vitrectomy

Ja Young Lee, MD¹, Mi Ri Rhee, MD², Kyung Seek Choi, MD, PhD¹, Sung Jin Lee, MD, PhD¹

¹Department of Ophthalmology, Soonchunhyang University College of Medicine, Seoul, Korea

²Myeong Eye Clinic, Seoul, Korea

Address reprint requests to Sung Jin Lee, MD, PhD Department of Ophthalmology, Soonchunhyang University Hospital #657 Hannam-dong, Yongsan-gu, Seoul 140-743, Korea Tel: 82-2-709-9354, Fax: 82-2-798-7797, E-mail: wismile@unitel.co.kr

Received 6 September 2010 Accepted 24 November 2010

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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 non-contact 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.

Keywords: Corneal endothelial cell loss, Gas tamponade, Phacoemulsification, Vitrectomy

References

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Figure 1.

An anterior segment photograph of the patient who underwent pars plana vitrectomy, phacoemulsification and gas tamponade 2 weeks later. The component of blood is located between the pseudophakic lens and posterior capsule immediately, and then collected in the center of the corneal endothelium after being prone position.

Table 1.

Comparison of endothelial cell densities (cells/mm ²) between groups

Endothelial cell density	Group 1 (n = 32)	Group 2 (n = 26)	Group 3 (n = 34)	Group 4 (n = 53)
Preoperative (mean ± SD)	2675.40 ± 290.90	2563.58 ± 387.80	2830.76 ± 222.81	2767.96 ± 304.12
Postoperative 12 wk (mean ± SD)	2672.16 ± 267.31	2274.27 ± 508.34^*	2602.32 ± 403.55^*	2392.72 ± 363.37^*
Endothelial cell loss (%)	-0.11%	10.27%^†	7.77%^†	13.16%^†

Values represent the mean ± standard deviation.

^* p < 0.05, compared with preoperative;

^† p < 0.05, compared with group 1.

Table 2.

Comparison of endothelial cell densities (cells/mm²) between groups after excluding 15 eyes with component of blood in he center of the corneal endothelium in group 2 and 4

Endothelial cell density	Group 1 (n = 32)	Group 2 (n = 20)	Group 3 (n = 34)	Group 4 (n = 44)
Preoperative (mean ± SD)	2675.40 ± 290.90	2500.65 ± 385.10	2830.76 ± 222.81	2459.73 ± 350.46
Postoperative 12 wk (mean ± SD)	2672.16 ± 267.31	2469.00 ± 363.06	2602.32 ± 403.55^*	2459.73 ± 350.46^*
Endothelial cell loss (%)	-0.11%	1.02%	7.77%^†	10.79%^†^‡

Values represent the mean ± standard deviation.

^* p < 0.05, compared with preoperative;

^† p < 0.05, compared with group 1;

^‡ p < 0.05, compared with group 2.

Table 3.

Comparison of endothelial cell densities (cells/mm²) between eyes of component of blood in the center of the corneal endo-thelium and the others in group 2 and 4

	Component of blood in corneal endothelium (n = 15)^†	The others (n = 64)
Preoperative (mean ± SD)	2687.83 ± 362.92	2755.60 ± 259.72
Postoperative 12 wk (mean ± SD)	1889.13 ± 351.57	2462.63 ± 351.57
Endothelial cell loss (%)	31.27%^*	7.74%

Values represent the mean ± standard deviation.

^* p < 0.001, tested by t-test, comparison with the others;

^† This data tested by normality, p < 0.05.

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