Comparison of central corneal thickness changes after cataract surgery: experienced surgeon versus training surgeons

Abstract

Purpose: To evaluate and compare the central corneal thickness (CCT) changes occurring after cataract surgery by phacoemulsification between 2 groups of operators: an experienced surgeon versus 2 training surgeons.

Methods: 120 consecutive patients were included in a prospective, comparative study between October and November 2013. Two groups were defined according to the operator performing surgery: an experienced surgeon (group 1) or 2 post-graduate surgeons (group 2). Operations were phacoemulsifications in micro-coaxial mode (2.2mm) with the Stellaris (Bausch&Lomb) machine and foldable soft lens implant. CCT was measured preoperatively and 2 hours postoperatively. Measurements were performed using a non contact pachymeter (Non Contact Tono / Pachymeter TONOPACHY™ NT-530P, Nidek). Collected data were: sex, age, operating duration, ultrasound (US) rate (%), US time (TPA), equivalent phaco-time (TPE, calculated time required if 100% power had been used throughout), and possible final suture. The Student’s t-test was used for statistical comparisons with threshold of significance p< 0.05

Results: 60 eyes were included in group 1, and 60 in group 2. Mean age was 72.09 years ± 8.87 (group 1) and 65.27 years ± 14.42 (group 2). Mean CCT increasing was significantly greater in group 2: 107.09 µm ± 99.02; versus group 1: 65.73 µm ± 46.37 (p= 0.002 IC 95% [-67.2; -15.5]). Mean US rates were comparable between groups: group 1 = 13.06 % versus group 2 = 10.91%. (p>0.05). Mean US times were comparable: group 1 = 47.90 s versus group 2 = 49.94 s (p>0.05). Mean equivalent phaco-time were comparable: group 1 = 6.35 s; versus group 2 = 6.01 s (p>0.05). Mean operating durations were significantly greater in group 2 = 14.64 min versus group 1 = 8.41 min (p = 0.006; IC 95% [-10.43; -2.16]). No significant correlations were found between post-operative CCT increasing and equivalent phaco-time or operating duration

Conclusions: Our study shows a significantly greater increasing of post-operative CCT and operating duration in the training surgeon group. However we don’t find any correlation between CCT and the other studied parameters: US equivalent time, operating duration

Keywords: 445 cataract • 505 edema • 481 cornea: endothelium