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R. Coste, D. Denis; Assessment of Corneal Endothelial Cell Loss With Pre and Postoperative Parameters in Cataract Surgery. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5448.
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© ARVO (1962-2015); The Authors (2016-present)
The aim of this study is to assess pre and postoperative parameters respective roll on corneal endothelial cell loss (ECL).
All patient presenting for cataract surgery from january to april 2009 were included. They were operated with same method, 3.2mm classical incision with divide and conquer technique. Everyone benefited cefuroxime intracameral injection. Age, sex, side, anesthesia mode, keratometry (Km), anterior chamber depth (ACD), axial lenght (AL). At 1 and 6 months were noted best corrected visual acuity (BCVA), central corneal thickness (CCT), endothelial cel density (ECD). Surgery time (T), absolute ultrasound time (US), balanced salt solution volume (BSS) were noted. Statistic analysis was perform with SPSS15.0 software.
90 patients were included, 63% female, 45 each side. Mean age is 72.8 years. Mean ECD in pre and postoperative were 2212±369, 1916cell/mm²±449 (M1) and 1969cell/mm²±479 (M6), ECL were 12.4%(M1) and 11.03% (M6), mean CCT were 521µ±36, 524µ±41 (M1) and 519µ±39 (M6), mean T was 16min±5, mean US was15sec±13, mean BSS was 324ml±96, pre and postoperative BCVA average were 0.41±0.23 and 0.81±0.23, mean ACD and AL were 3.03mm±0.37 and 24.54mm±1.88, mean keratometry was 43.66D±1.42. We found a significant statistic relation between ECL and age (p=0.034) preoperative ECD (p=0.002), ACD (p=0.019), US (p=0.001) and T (p=0.012). It was existing a correlation between ACD and AL (p<0.001), Km and AL (p=0.003), US and T (p=0.001), US and BSS (p=0.001), T and BSS (p<0.001).
The 11% ECL is conform to publication. Cefuroxime doesn't seem to increase ECL. An endothelial cell fragility time-acquered explain the results. Others factors were already knows on published study (T, US). Corneal endothelium needs to be preserved by optimazing operative parameters. Cefuroxime use doesn't seem deleterious for endothelial cells.
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