Predictive factors of Endothelial Cell Loss (ECL) after Phacoemulsification:
Percepolis ancillary study number 2

Abstract

Purpose : The aim of the study is to identify the predictive factors of ECL after phacoemulsification.

Methods : PERCEPOLIS is a prospective, comparative clinical trial, randomized in 2 parallel groups, conducted from June 2015 to July 2016. It evaluates the density of the central corneal endothelial cells before and after cataract surgery comparing two phacoemulsification techniques (Divide-and-Conquer vs Subluxation). PERCEPOLIS 2 is a secondary derived analysis of PERCEPOLIS, carried out in order to identify more precisely the predictive factors of ECL. The primary study outcome was ECL. The endothelial cell density (ECD) was measured preoperatively and postoperatively at 3 months by non-contact specular microscopy (Nidek CEM530). Were collected the following data: the surgical technique used, the operating time, the ultrasound power (US%), the ultrasound time (UST), the effective phacoemulsification time (EPT).

Results :
Our study involved 234 eyes of 132 women and 102 men; the average age of patients was 73.5 years (SD 10). Mean visual acuity was 0.42 logMAR (SD 0.18) before cataract and 0.09 logMAR (SD 0.07) at 3 months of intervention. Before surgery ECD was 2384 cell / mm2. At month 3 the ECL was 13.14% (SD 14.9). A bivariate analysis of factors potentially associated with ECL at month 3 found a correlation coefficient of 0.28 (p <0.01) for age, 0.06 (p = 0.38) for corneal thickness, 0.13 (p = 0.04) for the operating time, 0.23 (p <0.001) for ultrasound power, 0.24 (p <0.001) for UST and 0.36 (p <0.001) for the EPT. In multivariate analysis, however, the only significant remaining factor was EPT (p <0.001)

Conclusions : The EPT appears as the most correlated predictive factor with the final ECL. It seems relevant to make it appear systematically in operative reports.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.