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M. Casillas Gil, J. M. Perone, P. J. Bertaux, S. Rozenek, V. Wenger, M. Al Saoud, R. Jlaiel, R. Alami, G. Breazu, A. Popovici; Comparison of Endothelial Cell Loss After Cataract Surgery According to the Type Of IOL. Invest. Ophthalmol. Vis. Sci. 2008;49(13):401.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the endothelial cells loss after cataract surgery when using four differents types of IOL.
Retrospective study including 58 eyes. All the patients undergone standard cataract surgery with phacoemulsification, with topical anaesthesia (tetracaïne and oxybuprocaine) performed by the same surgeon, from May 2005 to July 2005. The type of IOL employed was chosen by the surgeon in the operating room, before starting surgery. 38%(22 eyes) were implanted with an Akreos Adapt IOL (Bausch & Lomb), 29%(17 eyes) with an AcrySof SN60AT IOL (Alcon Labs), 23%(13 eyes) with a Tripode IOL (Ioltech Labs) and 10%(6 eyes) with an ACR6D IOL (Corneal, Pringy, France). An endothelial cell count was performed pre-operatively and 1 month after surgery, using the same non contact specular microscope (Topcon SP 2000).
There was no significant difference between the four groups on the criteria of age, difficulty of intervention, average operation time and power of the lens. The mean (SD) of cell counts performed before surgery were not significantly different in the four groups: 2401 (424) in Akreos Adapt group, 2492 (266) in Acrysof SN60AT group, 2549 (273) in Tripod group and 2462 (546) in ACR6D group (p=0,70). The mean (SD) percentage of cellular decrease was 8,6%(7,3%) in Akreos Adapt group, 9,7%(7,7%) in AcrySof SN60AT group and 7,7%(5,4%) in ACR6D group, and it was 4,1%(3,5%) in Tripode group (ANOVA test p=0.13). Even if the ANOVA test does not show a significant difference between the four groups, the endothelial cell loss after cataract surgery tends to be less important when using a Tripode IOL. The mean (SD) percentage of cell loss was 4,1% (3,5%) in the Tripod group compared with homogeneous higher loss in the 3 other groups: 8,9% (7,2%) for these 3 groups cumulated. This lack of statistical significance could be due to an insufficient groups sizes. To confirm this first hypothesis, a prospective study, randomised on the type of IOL, with larger groups (about 40 people in each group to be statistically correct) would be needed. The reasons of this assumed protection of endothelial cells when using the Tripode IOL are to be found.
This exploratory study seems to indicate a less important loss of endothelial cells when using the Tripod IOL. This hypothesis has to be confirmed by a randomised study.
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