Clinical Specular Microscopy and Intraocular Surgery

Abbott, Richard L.; Forster, Richard K.

doi:10.1001/archopht.1979.01020020138010

Cited by 61 publications

(8 citation statements)

References 22 publications

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“…The average amount of endothelial cell loss was similar in the mepivacaine and placebo groups, being approximatly 6%, a percentage corresponding to that reported in other studies in a similar surgery 13. Similarly, our results also show the absence of induction of any inflammatory reaction or elevation of IOP, after the operation and in the longer term follow up.…”

Section: Discussionsupporting

confidence: 91%

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Pain relief with intracameral mepivacaine during phacoemulsification

Malecaze

Deneuville²,

Julia³

et al. 2000

British Journal of Ophthalmology

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)) while remaining unchanged in the placebo group (2.9 (2.6-3.2) v 2.9 (2.5-3.3)), the mean reduction in pain score being significantly diVerent between the two groups (p<10 −4 ). There was no indication of increased postoperative ocular inflammation, intraocular pressure change, or endothelial cell loss. Conclusions-These results suggest that it may not be necessary to systematically add intracameral anaesthesia with topical anaesthesia for cataract surgery. An intraoperative intracameral injection, performed only in patients who happen to suVer during surgery, is safe and eVective. (Br J Ophthalmol 2000;84:171-174) Cataract surgery using topical anaesthesia has recently become considerably more popular. This type of anaesthesia avoids complications associated with general or locoregional anaesthesia, and seems ideally suited for ambulatory surgery in view of the preoperative and postoperative comfort oVered to the patient. Its principal drawback is intraoperative pain in 5% to 10% of the patients.

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Section: Discussionsupporting

confidence: 91%

“…On the one hand we knew that the percentage of endothelial cell loss is generally estimated at about 7% (SD 3%) after phacoemulsification 13. On the other hand we also knew that the inflammatory reaction at day 1, assessed by the flare values, is generally about 50 (SD 20) photons/ms, in the absence of an intracameral anesthetic treatment.…”

Section: Methodsmentioning

confidence: 99%

Pain relief with intracameral mepivacaine during phacoemulsification

Malecaze

Deneuville²,

Julia³

et al. 2000

British Journal of Ophthalmology

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“…Intraocular surgery has been shown to decrease endothelial cell counts [111,112]. Antimetabolites often used in trabeculectomy can be toxic to the corneal endothelium [113].…”

Section: Results Of the Collaborative Corneal Transplantationcontrasting

confidence: 39%

Graft failure: III. Glaucoma escalation after penetrating keratoplasty

Greenlee

Kwon

2008

Int Ophthalmol

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Glaucoma after penetrating keratoplasty is a frequently observed post-operative complication and is a risk factor for graft failure. Penetrating keratoplasty performed for aphakic and pseudophakic bullous keratopathy and inflammatory conditions are more likely to cause postoperative glaucoma compared with keratoconus and Fuchs' endothelial dystrophy. The intraocular pressure elevation may occur immediately after surgery or in the early to late postoperative period. Early postoperative causes of glaucoma include pre-existing glaucoma, retained viscoelastic, hyphema, inflammation, pupillary block, aqueous misdirection, or suprachoroidal hemorrhage. Late causes include pre-existing glaucoma, angle-closure glaucoma, ghost cell glaucoma, suprachoroidal hemorrhage, and steroid-induced glaucoma. Determining the cause of IOP elevation can help guide therapeutic intervention. Treatments for refractory glaucoma include topical anti-glaucoma medications such as beta-adrenergic blockers. Topical carbonic anhydrase inhibitors, miotic agents, adrenergic agonists, and prostaglandin analogs should be used with caution in the post-keratoplasty patient, because of the possibility of corneal decompensation, cystoid macular edema, or persistent inflammation. Various glaucoma surgical treatments have reported success in post-keratoplasty glaucoma. Trabeculectomy with mitomycin C can be successful in controlling IOP without the corneal toxicity noted with 5-fluorouracil. Glaucoma drainage devices have successfully controlled intraocular pressure in postkeratoplasty glaucoma; this is, however, associated with increased risk of graft failure. Placement of the tube through the pars plana may improve graft success compared with implantation within the anterior chamber. In addition, cyclophotocoagulation remains a useful procedure for eyes that have refractory glaucoma despite multiple surgical interventions.

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“…The results of this study demonstrate that a significant endothelial cell loss occurs in each region of the cornea following ICCE. A reduction of the central endothelial cell density in our series was comparable with previous studies (Bourne & Kaufman 1976;Hirst et al 1977;Abbot & Forster 1979;Galin et al 1979;Kraff et al 1980;Liesegang et al 1984), demonstrating a mean cell loss of 17.5% after 6 months of follow-up. By comparision, the superior cell loss was twice greater than the central cell loss.…”

Section: Discussionsupporting

confidence: 92%

Regional specular microscopy of endothelial cell loss after intracapsular cataract extraction: A preliminary report

Inaba¹,

Matsuda²,

Shiozaki³

et al. 1985

Acta Ophthalmologica

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In a group of 10 patients (12 eyes) undergoing intracapsular cataract extraction, corneal endothelial cell loss was serially investigated by means of regional specular microscopy. Prevoperatively there were no significant regional differences in the endothelial cell density. Two weeks after surgery, the superior endothelium alone showed a significant cell loss (15.6%). Whereas, a definite endothelial cell loss occurred in each region of the cornea one month after surgery. The cell loss was greater in the superior (22.8%) and lower in the inferior (4.7%), respectively, when compared to that seen in the central cornea (9.6%). In each region, cell loss continued 3 months postsoperatively, but no significant cell loss occurred thereafter. These results suggest that the entire endothelial cell population may participate in the healing of the damage associated with intracapsular cataract extraction and that regional specular microscopy can be of help for detailed evaluation of such a damage.

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Clinical Specular Microscopy and Intraocular Surgery

Cited by 61 publications

References 22 publications

Pain relief with intracameral mepivacaine during phacoemulsification

Pain relief with intracameral mepivacaine during phacoemulsification

Graft failure: III. Glaucoma escalation after penetrating keratoplasty

Regional specular microscopy of endothelial cell loss after intracapsular cataract extraction: A preliminary report

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