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Ricardo Moreno, Alejandro Zermeno, Flor Daniela Guzman, Marisol Garzon, Mara Barba; Specular Microscopy Changes After Phacoemulsification Surgery Performed by Ophthalmology Residents. Invest. Ophthalmol. Vis. Sci. 2017;58(8):772.
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© ARVO (1962-2015); The Authors (2016-present)
To describe the corneal endothelial cell characteristics and the risk factors for endothelial cell loss after phacoemulsification performed by residents in an ophthalmology Center in Mexico City.
We reviewed the clinical records of 112 eyes of 84 patients who underwent cataract surgery by an ophthalmology resident under the supervision of an experienced surgeon from March 2016 through August 2016. The endothelial cell density (ECD), percentage of hexagonal cells, endothelial cell area (ECA), coefficient of variation (CV), and central corneal thickness (CCT) were measured preoperatively and 3 months after surgery with a noncontact specular microscope Nike CEM-530. The variables examined to assess the risk for corneal endothelial cell loss postoperatively were patient age, cataract grade (LOCS classification), phacoemulsification technique, anterior chamber depth (ACD), axial length, cumulative dissipated energy (CDE) and presence of diabetes mellitus.Patients with complications during the surgical procedure were excluded.
The mean age was 65 years and the average endothelial cell loss was 18.6%. Preoperative and postoperative specular microscopy showed changes in endothelial cell density 2300.1 cells/mm2 versus 1872.2 cells/mm2 ; coefficient of variation, 29.5 % versus 35.7% ; percentage of hexagonality, 67.1% versus 64.6% ; and central corneal thickness, 535 μm versus 540 μm. CDE > 25 and nuclear LOCS >3.5 (either opalescence or color) were independent risk factors for endothelial cell loss. No statistically significant difference was found in the other variables.
The corneal endothelial cell loss is one of the main concerns of cataract surgery in the hands of an ophthalmologist in training. Choosing the appropiate patient can lead to good results and quick learning curve. Phacoemulsification cataract surgery was a safe technique in the hands of a supervised resident.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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