Corneal Endothelial Cell Loss After Cataract Extraction by Using Ultrasound Phacoemulsification Versus a Fluid-based System

Richard, Jérôme; Hoffart, L.; Chavane, Frédéric; Ridings, B.; Conrath, J.

doi:10.1097/ico.0b013e3181583115

Cited by 56 publications

(38 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…24 In contrast, pseudophakic bullous keratopathy (PBK) is an acquired corneal endothelial disorder that may occur following intraocular cataract extraction surgery. 25 Various causative factors such as excessive phacoemulsification energy 26 and mechanical trauma 27 to the corneal endothelium during cataract extraction surgery have been implicated in causing stress-induced apoptosis of CECs. 28 Although PBK is characterized by diffuse damage to the corneal endothelial layer, 29 a peripheral rim of healthy CECs and DM is usually retained in corneas affected by FED.…”

mentioning

confidence: 99%

Predicative Factors for Corneal Endothelial Cell Migration

Soh

Peh

George

et al. 2016

Invest. Ophthalmol. Vis. Sci.

View full text Add to dashboard Cite

PURPOSE.To characterize the effects of Descemet's stripping, Rho-associated protein kinase inhibitor Y-27632, and donor age on endothelial migration in human corneas maintained in ex vivo culture.METHODS. Twenty-eight cadaveric human corneas underwent ex vivo culture in either standard or Y-27632-supplemented culture medium for 14 days. The posterior surface of each cornea was manipulated to create two types of wounds: scratched wound-corneal endothelial cells (CECs) were denuded from the Descemet's membrane (DM) to leave behind a bare but intact DM; and peeled wound-both the DM and overlying CECs were stripped to leave behind bare corneal stroma. Endothelial migration was assessed via Trypan blue staining. Morphologic traits of CECs were assessed via Alizarin red microscopy and scanning electron microscopy.RESULTS. The CECs migrated preferentially over scratched wounds compared with peeled wounds. Y-27632 supplementation accelerated endothelial migration over scratched wounds. Endothelial migration decreased with advanced donor age for both wound types, regardless of exposure to Y-27632. Y-27632 supplementation resulted in a less rapid decline in endothelial migration for donors older than 50 years of age for scratched surfaces. Greater cell density and hexagonality was observed over scratched wounds compared with peeled wounds, regardless of Y-27632 supplementation.CONCLUSIONS. The presence of an intact DM, Y-27632 supplementation, and young donor age are factors that promote endothelial migration in an ex vivo human cornea culture model. The negative effect of age on endothelial migration can be mitigated by the presence of an intact DM and Y-27632 supplementation.

show abstract

mentioning

confidence: 99%

Predicative Factors for Corneal Endothelial Cell Migration

Soh

Peh

George

et al. 2016

Invest. Ophthalmol. Vis. Sci.

View full text Add to dashboard Cite

show abstract

“…The insignificant endothelial cell loss of 4.1% in this group is quite low when compared to other studies on phacoemulsification which have shown endothelial losses ranging from 4 to 25% [4,21,22,23,24,25,26]. …”

Section: Discussionmentioning

confidence: 72%

“…There is a study by Richard et al [4] that suggests that Aqualase has a less deleterious effect on the corneal endothelium than phacoemulsification. One month after surgery, the corneal endothelial loss was 24.3% in the phacoemulsification group versus only 11.2% in the Aqualase group.…”

Section: Discussionmentioning

confidence: 99%

“…In the study of Richard et al [4], no classification of the nuclear opalescence grade was performed. The high endothelial cell loss found in this study indicates that probably higher density cataracts were included.…”

Section: Discussionmentioning

confidence: 99%

“…In particular, it is unclear whether and to what extent the nuclear opalescence grade has an effect on the endothelial damage. Although this technique is often considered to be suitable especially for soft nuclei some authors found an endothelial cell loss independent of nuclear density [4,5,6,7]. …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Aqualase® Revisited: Endothelial Cell Loss Strongly Depends on Lens Density

Bergholz²,

Gonnermann³

et al. 2013

Ophthalmic Res

View full text Add to dashboard Cite

Purpose: To analyze the dependence between corneal endothelial cell loss by Aqualase® cataract surgery and the nuclear opalescence grade of the lens. Patients and Methods: A total of 100 eyes of 92 patients were enrolled in this prospective, single-center study. Patients were randomly assigned to the Aqualase (50 eyes) or the phacoemulsification group (50 eyes). The nuclear density was classified with the Lens Opacities Classification System III. All procedures were performed by the same surgeon. Preoperatively and 1 week postoperatively, endothelial cell counts were obtained using a noncontact specular microscope (Konan, Japan). Results: (1) Aqualase group: the group of patients with a nuclear density of 1-2 (17 patients) showed no significant endothelial cell loss (4.1%, p = 0.163). The endothelial cell loss in grade 3 cataracts (28 eyes) was 13.9% (p = 0.004) and in grade 4 cataracts (5 eyes) 69.1% (p = 0.043), being statistically significant in both groups. (2) Phacoemulsification group: in nuclear density groups 1 and 2, endothelial cell loss was 6.3% (p = 0.41), in group 3 it was 17.6% (p = 0.001) and in group 4 it was 14.9% (p = 0.08). Only in nuclear opalescence grade 4 there was a significant difference between the Aqualase and the phacoemulsification procedure (p = 0.008). Conclusion: Endothelial cell loss by Aqualase technology depends strongly on the nuclear opalescence grade. In low- and medium-density cataracts, Aqualase does not seem to provoke significant endothelial cell loss. Due to very high endothelial loss in hard nuclei, Aqualase is unsuitable for these cataracts.

show abstract

Preliminary clinical investigation of cataract surgery with a noncontact femtosecond laser system

Wang

et al. 2015

Lasers Surg. Med.

View full text Add to dashboard Cite

Background and ObjectiveFemtosecond laser‐assisted cataract surgery (FLACS) is rapidly gaining popularity due to the improved consistency and predictability for capsulorhexis. This study aimed to investigate the preliminary clinical outcomes of FLACS with a noncontact femtosecond laser system.Patients and MethodsThis prospective study enrolled 25 eyes in the trial group underwent FLACS (LLS‐fs 3D, LENSAR, USA), and 29 eyes in the control group underwent conventional cataract surgery (Stellaris, Bausch & Lomb, USA). The phacoemulsification time, energy, and complications during operation were recorded. Postoperative refraction at 1 day, 1 week, 1 and 3 months, the capsulorhexis size and corneal endothelial density at 1 and 3 months were also measured.ResultsCompared to the control group, reduction in phacoemulsification time was 51.5% (P = 0.02), and in overall energy, 65.1% (P = 0.02) in the trial group. In the trial group and the control group, total time of cataract procedure was 10.04 ± 1.37 minutes, 10.52 ± 1.92 minutes, respectively (P = 0.31); the absolute difference between attempted and achieved capsulorhexis diameter at 1 month was 192.9 ± 212.0 µm, 626.9 ± 656.6 µm, respectively (P = 0.04), and at 3 months, 256.6 ± 181.9 µm, 572.1 ± 337.0 µm, respectively (P= 0.03); the absolute difference between attempted and achieved spherical equivalent at 3 months was 0.16 ± 0.16 D, 0.74 ± 0.65 D, respectively (P < 0.01); mean corneal endothelial cell loss at 1 month was 15.6% and 14.2%, respectively (P = 0.77), and at 3 months, 2.9%, 4.2%, respectively (P = 0.50).ConclusionsWith the noncontact femtosecond laser system, FLACS can significantly improve the accuracy and repeatability of capsulorhexis, reduce the phacoemulsification time and overall energy, and enhance the predictability and stability of postoperative refraction. Lasers Surg. Med. 47:698–703, 2015. © 2015 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.

show abstract

Corneal Endothelial Cell Loss After Cataract Extraction by Using Ultrasound Phacoemulsification Versus a Fluid-based System

Abstract: Our study showed significantly lower ECL after phacoemulsification for a fluid-based versus an ultrasound system. The fluid-based method was safer than conventional ultrasound in cataract surgery, with a nuclear opalescence graded up to 4.9 in the LOCS III classification.

Cited by 56 publications

References 28 publications

Predicative Factors for Corneal Endothelial Cell Migration

Predicative Factors for Corneal Endothelial Cell Migration

Aqualase® Revisited: Endothelial Cell Loss Strongly Depends on Lens Density

Preliminary clinical investigation of cataract surgery with a noncontact femtosecond laser system

Contact Info

Product

Resources

About