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Abstract
Purpose
To evaluate the short-term clinical outcome of cataract surgery using torsional mode phacoemulsification for patients with low endothelial cell density.
Methods
Fifty-seven eyes of 52 patients who underwent torsional phacoemulsification and intraocular lens insertion were included in the present study. Patients were divided into groups according to endothelial cell density (ECD). The control group was comprised of patients with more than 2500/mm2 of ECD and was compared with the low ECD group (LECD) comprised of patients with less than 1600/mm2 of ECD. The LECD group was further divided into a very low ECD group (VLECD) comprised of patients with less than 1000/mm2 of ECD, and a PK-VLECD group comprised of patients with less than 1000/mm2 of ECD after penetrating keratoplasty. Measurement of ECD, cell-size variation coefficient, hexagonality, and central corneal thickness were performed preoperatively and 1 month after surgery.
Results
The only one patient who had undergone penetrating keratoplasty with remaining low endothelial density and grade 4 nuclear sclerosis developed overt corneal edema after cataract surgery. No statistically significant differences in the change of endothelial cell characteristics and central corneal thickness before and after surgery were observed between the control and LECD group and between the VLECD and PK-VLECD group.
References
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Figure 1.
Comparison of endothelial cell loss after cataract surgery in the control and low endothelial cell density group (LECD), very low endothelial cell density group (VLECD) and very low endothelial cell density after penetrating keratoplasty groups (PK-VLECD). There was no statistically significant difference between the control and LECD group, and also between VLECD and PK-VLECD group (p>0.05).
Figure 2.
Comparison of cell size variation coefficient (CV) after cataract surgery in the control and low endothelial cell density group (LECD), very low endothelial cell density group (VLECD) and very low endothelial cell density after penetrating keratoplasty groups (PK-VLECD). There was no statistically significant difference between the control and LECD group, and also between VLECD and PK-VLECD group (p>0.05).
Figure 3.
Comparison of hexagonality (6A) after cataract surgery in the control and low endothelial cell density group (LECD), very low endothelial cell density group (VLECD) and very low endothelial cell density after penetrating keratoplasty groups (PK-VLECD). There was no statistically significant difference between the control and LECD group, and also between VLECD and PK-VLECD group (p>0.05).
Figure 4.
Comparison of central corneal thickness (CCT) after cataract surgery in the control and low endothelial cell density group (LECD), very low endothelial cell density group (VLECD) and very low endothelial cell density after penetrating keratoplasty groups (PK-VLECD). There was no statistically significant difference between the control and LECD group, and also between VLECD and PK-VLECD group (p>0.05).
Table 1.
Demographics of patients
| Variable | LECD | Control | p-value |
|---|---|---|---|
| No. of patients | 25 | 27 | - |
| No. of eyes | 28 | 29 | - |
| Sex (M/F) | 9/16 | 12/15 | 0.535* |
| Age (years) | |||
| Mean | 62.46 ± 12.73 | 63.62 ± 11.64 | 0.804† |
| Range | 34-78 | 44-84 | |
| Nuclear opacity | 2.21 ± 1.10 | 2.31 ± 1.20 | 0.726† |
| Phaco time (s) | 91.94 ± 87.23 | 89.24 ± 68.97 | 0.856† |
| Phaco energy (%) | 9.20 ± 5.56 | 11.04 ± 4.95 | 0.268† |
| BSS used (ml) | 134 ± 69 | 109 ± 52 | 0.521† |
| Incision (Sup/Temp) | 5/23 | 7/22 | 0.561* |
| Mean Preop BCVA (log MAR) | 1.14 ± 0.56 | 0.7 ± 0.57 | 0.002† |
Table 2.
Preoperative diagnoses of corneas in patients with low endothelial cell density
Table 3.
Comparison of endothelial cell changes between the control, low endothelial cell density group (LECD), very low endothelial cell density group (VLECD), and very low endothelial cell density after penetrating keratoplasty groups (PK-VLECD)
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