Anterior Segment Parameters Using Pentacam and Prediction of Corneal Endothelial Cell Loss after Cataract Surgery

Abstract

PurposeWe evaluated various preoperative anterior segment parameters measured with a Pentacam rotating Scheimpflug camera and compared them with those of conventional methods. We also evaluated the effect of different parameters on corneal endothelial cells after cataract surgery.MethodsPentacam examination was performed in 88 eyes from 88 patients to evaluate central anterior chamber depth (ACDpentacam), nuclear density (Densitometrypentacam), anterior chamber volume (ACV), and lens thickness (LTpentacam). We compared values of ACDpentacam with those of ultrasound (ACDsono) and also compared Densitometrypentacam values with those of Lens Opacities Classification System (LOCS III) classification. We evaluated the effect of the following preoperative values measured with Pentacam on postoperative endothelial cell loss: pupil size measured both preoperatively and before capsulorrhexsis (PupilCCC), amount of viscoelastics, and LT measured by ultrasound (LTsono).ResultsA significant concordance was found between the two grading methods of nuclear opacity: Densitometrypentacam and LOCS III classification (τb = 0.414, p = 0.000). We also found a positive correlation between ACDpentacam and ACDsono (r = 0.823, p = 0.000) and between ACDpentacam and ACV (r = 0.650, p = 0.000). There were significant differences between the results of LTpentacam and LTsono. The final regression model identified Densitometrypentacam, viscoelastics and PupilCCC as independent predictors of decreased postoperative corneal endothelial cell density (CD) at postoperative day 3, and Densitometrypentacam, viscoelastics, and ACV as independent predictors of decreased CD two months postoperatively (p<0.05).ConclusionsGood agreement was found between all results obtained with the Pentacam and conventional methods except LT. Analyzing anterior chamber parameters preoperatively using Pentacam could be helpful to predict postoperative endothelial cell loss.

Influence of anterior chamber depth, anterior chamber volume, axial length, and lens density on postoperative endothelial cell loss

“…Another study found a mean LD of 11.95 %±4.06 % with a mean nuclear opacity of 3.07 within the LOCS III classification, comparable to our result of LD. In their study, LD could be identified as a risk factor for predicting percentage change of endothelial cell density, which we did not show in our study [20]. LD only reached a small range from 7.1 to 34.1 % within the study by Cho et al, so they concluded that the clinical opacitiy classification might have been overestimated.…”

“…ACV was calculated using integral calculus. In our study, ACV was calculated within the Pentacam software [20].…”

Wavefront-optimized excimer laser in situ keratomileusis for myopia and myopic astigmatism: Refractive outcomes and corneal densitometry

“…11,13,32 Corneal densitometry has been assessed, and the degree of subepithelial corneal haze and stromal scarring in refractive surgery patients has been quantified. 9,10,12 Most studies used slitlamp observation and subjective assessment to report haze after keratorefractive surgery.…”

“…[8][9][10] The Pentacam (Oculus Optikger€ ate GmbH) is a noninvasive optical system that uses the Scheimpflug principle to take up to 50 cross-sectional images of the entire anterior segment within 2 seconds. 11 The ability to measure changes in corneal transparency noninvasively and objectively may enable more precise monitoring of progression and may improve patient management.…”

Normal Values of Corneal Optical Densitometry Using Pentacam Scheimpflug Camera

“…Corneal densitometry provides information about corneal clarity and thus an indication of cornea health. Densitometry is expressed in grayscale unit from 0 to 100; 0 means minimum backscattering of light (no clouding) and 100 means maximum backward scattering of light (opaque) [12]. An example of the data output is shown in figure 10.…”