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Mathilde Boiché, Cedric Ghetemme, adina Agapie, Francois Ameloot, Shanour Premy, Oualid Guechi, Fanny Tréchot, Louis Lhuillier, Naïla HOUMAD, Jean-Marc Perone; Correlation between postoperative central corneal thickness and endothelial damage after cataract surgery by phacoemulsification.. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):659.
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© ARVO (1962-2015); The Authors (2016-present)
To study the correlation between postoperative corneal oedema and endothelial cell loss after cataract surgery by microcoaxial phacoemulsification.<br />
Fifty eyes of 36 consecutive patients, who were diagnosed with a mild cataract(up to C5, N4, P5 on the classification LOCS III), were included in a prospective study from September 2014 to November 2014. Pachymetry and endothelial cell density measurements were taken preoperatively, one hour after surgery, and 4 and 15 days after the surgery, using CEM 530non-contact specular microscopy (Nidek CO Ltd, Gamagori, Aichi, Japan). Every surgery was performed using Stellaris device (Bausch&Lomb) on microcoaxial mode, with 2,2 mm incision. Other parameters collected were sociodemographic factors, surgical duration, effective US time (TPE) and type of IntraOcularLense. Patients with corneal diseases (cornea guttata) were not included.
Mean age was 74,5 +/-3,7 years. Sex-ratio was 0,94 with 48,5% males. Mean surgical time was 8min (+/- 1,5) and the mean TPE was 7,33 sec (+/- 1,45). Mean central corneal thickness augmentation was 38,3 µm (+/- 13,3) one hour after the surgery (an average pachymetry’s increase of 6,27% +/- 2,6), 6,3µm (+/- 7,9) 4 days after(D4) and disappeared at day 15 (D15). Main endothelial cell loss was 8,5 % (+/- 0,81) at D4 and 9,03% (+/- 4,79) at D15. Endothelial cell density was 2490 c/mm2 (+/- 86) before surgery, 2327 c/mm2 (+/- 164) at D4 and 2112 c/mm2 (+/- 291) at D15. At D4, significant endothelial loss (> 15%) were mostly related to a significant corneal oedema (> 15%), while low postoperative oedema (<5%) did not lead to significant endothelial loss (loss<5%). At D15, endothelial cell loss seems to be closely correlated with immediate post-operative oedema.<br />
Many studies have investigated the factors influencing endothelial cell loss after phacoemulsification. To our knowledge, none has studied the relevance of postoperative oedema as endothelial damage marker. In our study, we demonstreted an association between immediate postoperative corneal oedema and endothelial cell loss. This association needs to be clarified by further studies. Postoperative corneal thickness measurement may therefore become a marker of endothelial damage after phacoemulsification.<br />
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