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Alla Varavka, Alexei Zagorulko, Sergey Shukhaev; Long-Term Outcomes Of Phacoemulsification And Laser Cataract Extraction In The Eyes With Fuchs' Endothelial Dystrophy. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4727.
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To evaluate corneal endothelium three years following phacoemulsification (PE) and laser cataract extraction (LCE).
This retrospective study included 73 patients (73 eyes). Inclusion criteria were the following: 1) nuclear density NC2-NC4 (LOCS III classification); 2) visible cornea guttata area not exceeding 50% of the entire endothelium surface; 3) no previous eye surgery; 4) absence of any eye disease except AMD. 40 patients underwent uncomplicated PE and 33 had LCE. Before surgery and three years after surgery, endothelial biomicroscopy (using Tomey EM-300 specular microscope, USA) was performed in two areas: cornea guttata and clear cornea to evaluate endothelial cell loss, polymegathism (CV - coefficient of variation of cell size), and pleomorphism.
Before surgery, mean endothelial cell density in guttata area, was 730±83 cells per mm2 (n=23). In other 50 patients, cell counts could not be performed due to undetectable cell edges. Endothelial cell density of clear cornea was 2199±215 cells per mm2 (n=73). Mean endothelial cell loss in guttata area was less than 3% in both groups (p>0.05). Mean endothelial cell loss in clear cornea was 7.7% in the PE group and 5.4% in the LCE group. Mean CV was 48±5.1 in the PE group and 52±4.3 in the LCE group, with no significant difference between the groups (p>0.05). Mean number of hexagonal cells was approximately the same in both groups: 44% for the PE and 41% for the LCE (p>0.05).
Phacoemulsification and laser cataract extraction were safe for corneal endothelium in long-term observational period. The level of "endothelial stress" was approximately equal in both procedures.
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