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V. Arun, T. Alexandrou, M. Saidel, S. Ksiasek, W. Mieler; Changes in Corneal Thickness After Cataract Extraction in Patients Over 75 Years Old, With Reference to Endothelial Cell Counts. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3520.
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Corneal edema is a problem in elderly patients who undergo cataract surgery which delays visual recovery. Endothelial cell loss after cataract surgery has been previously described to be between 200-500 cells. In order to quantify the change in corneal thickness in patients over age 75 who undergo cataract extraction in correlation to preoperative endothelial cell count, corneal thickness measurements as well as pre- and postoperative endothelial cell counts were recorded to identify those who would benefit from more careful surgical planning.
Corneal thickness measurements were recorded in all patients over the age of 75 before surgery as well as one day, one week and one month postoperatively. Endothelial cell counts were recorded in patients prior to surgery as well as one month postoperatively.
50 patients over the age of 75 who underwent cataract surgery were reviewed and corneal thickness measurements showed a statistically significant increase in corneal thickness in patients with lower endothelial cell counts less than 1850 compared to patients with higher endothelial cell counts greater than 1850. The corneal edema is more easily treated in those patients with endothelial cell counts greater than 1850 followed over the one month follow-up period.
Patients with lower endothelial cell counts are at higher risk of corneal edema. Those at risk patients would benefit from shorter phaco times as well as frequently dosed topical agents to decrease corneal edema immediately postoperatively in order to improve visual recovery. Further testing needs to be conducted to confirm the validity of our results.
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