Corneal endothelial cell loss following cataract surgery in patients with pseudoexfoliation syndrome: a 2‐year prospective comparative study

Abstract

Purpose: To compare the corneal endothelial cell density (ECD) before and after cataract surgery in patients with and without pseudoexfoliation syndrome (PEX). Methods: In this prospective study, we compared the ECD in 62 PEX patients with 62 patients without PEX (controls). The mean age was 78.3 AE 6.2 years and 77.2 AE 5.9 years, respectively. Patients were examined before and at 6 months, 1 year and 2 years after cataract surgery. The corneal endothelium was examined with confocal microscopy, and the ECD was counted both automatically and semi-manually. Nine patients in the PEX group (15%) and 11 patients in the control group (18%) were lost to follow-up in the 2-year period. Within the PEX and the control groups, we also compared the ECD between patients with and without glaucoma. Results: Before surgery, the ECD (semi-manual counting) was 2258 AE 342 cells/mm 2 in the PEX group and 2322 AE 321 cells/mm 2 in the control group (p = 0.29). There were no significant differences in postoperative ECD between these groups at any visit. After 2 years, the ECD had changed by À679 AE 337 cells/mm 2 and À704 AE 484 cells/mm 2 , respectively (p = 0.78). The preoperative ECD was lower in eyes with glaucoma compared to eyes without glaucoma, both within the PEX group (p = 0.05) and the control group (p = 0.03). After surgery, there were no differences between eyes with or without glaucoma. Conclusion: The ECD was not significantly different in PEX eyes compared with control eyes, neither before nor after cataract surgery. However, there seemed to be a lower ECD in eyes with glaucoma before surgery.

Impact of Pseudoexfoliative Syndrome on Effective Lens Position, Anterior Chamber Depth Changes, and Visual Outcome After Cataract Surgery

“…The data of Ning and Kim are in line with our findings: In the current study, no significant difference in ACD change, as an indicator of ELP, between groups with a delta of 1.75 ± 0.77 mm in the PEX group and 1.81 ± 0.61mm in the control group was demonstrated. Kristianslund et al 22 focused on the corneal endothelial cell loss following cataract surgery in patients with PEX and also evaluated the DCVA. Preoperatively, the groups were comparable regarding the DCVA with 0.34 ± 0.25 logMAR in the PEX eyes and 0.25 ± 0.18 logMAR for the control group (p= 0.03).…”

“…Kristianslund et al 22 focused on the corneal endothelial cell loss following cataract surgery in patients with PEX and also evaluated the DCVA. Preoperatively, the groups were comparable regarding the DCVA with 0.34 ± 0.25 logMAR in the PEX eyes and 0.25 ± 0.18 logMAR for the control group (p= 0.03).…”

Kataraktkirurgi i Norge 2010–19

“…Dette har derimot blitt vist i Sverige, der man på 1990-tallet fant en betydelig overhyppighet av kvinner blant de kataraktopererte (8). Samme tendens er også vist i kliniske studier i Norge (10,11), USA (15) og en rekke andre land. Man har diskutert om denne forskjellen kan vaere relatert til biologiske endringer i linsens aldersutvikling, forskjellig oppfattelse av synsplager ( 16), ulik tendens til å henvise kvinner og menn til kirurgi (17) og lengre levealder for kvinner.…”

“…Man har tidligere hevdet at kvinner har en økt risiko for å utvikle katarakt, eller i alle fall at de hyppigere gjennomgår kataraktkirurgi. Dette samsvarer med funn i enkeltstudier fra Norge (10,11), men også for kjønnsfordelingen mangler det informasjon fra et større nasjonalt pasientmateriale.…”

Feasibility, efficacy and safety of early lens extraction in patients with pseudoexfoliation glaucoma: a feasibility and pilot study

“…In our small sample, we have not found any adverse event related to the surgery or a lower endothelial cell count after the intervention. A prospective study has been published [ 37 ] analyzing endothelial damage secondary to cataract surgery in pseudoexfoliative patients compared to a non-PXF control group. The results show that there are no significant differences at 2 years between groups in the corneal endothelial cell loss.…”