Corneal Endothelial Damage Associated by Phacoemulsification

Binder, Perry S.; Sternberg, Harvey; Wickham, M. Gary; Worthen, David M.

doi:10.1016/0002-9394(76)90663-2

Cited by 94 publications

(36 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Many researchers have suggested guidelines for maximum accuracy of specular microscope analysis. Binder et al [15] expanded the guideline by suggesting "as many cells in the image frame as possible, with 3 images per patient from the center and para central regions with the average analysis of all 3 images to give estimated cell density count".…”

Section: Corneal Endothelial Changes In Correlation With Corneal Thicmentioning

confidence: 99%

Corneal Endothelial Changes in Correlation with Corneal Thickness after Phacoemulsification among Diabetic Patients

Elbassiouny¹

2017

AOVS

View full text Add to dashboard Cite

Submit Manuscript | http://medcraveonline.com MethodsWe prospectively examined 23 eyes of each group of patients who were scheduled to have phacoemulsification surgery. Materials were collected from December 2016 till April 2017. Exclusion criteria were a history of previous ocular surgery or inflammation, abnormal findings by slit-lamp biomicroscopic examination, a small pupil diameter after a full dilation of less than 4.0 mm, and a preoperative endothelial cell density of less than 1500 cells/mm 2 . One surgeon performed all the surgeries. Specular microscopy was used on all eyes preoperatively, one week and one month postoperatively. Three photographs were taken per eye at each examination, and the mean of the measurements were calculated. The CCT (central corneal thickness), ECD (endothelial cell density), and CV (coefficient of variance) will be measured in all cases by automated analysis of the whole image. Complete medical history for type 2 diabetes based on medical history, blood glucose levels and HbA1c levels. Examination of visual acuity, subjective refraction, slit-lamp examination, IOP readings with applanation tonometry was done to all patients. Binocular indirect ophthalmoscopy was conducted for fundus examination.The density of the cataract was clinically graded by the same examiner on a scale of 1 to 6 using the Lens Opacities Classification system lll. IOL power and AC depth were recorded for all patients. A standardized stop and chop phacoemulsification technique was done with the phaco tip of 'white star Signature Pro®' Phaco-machine. Surgical techniques were conducted using retrobulbar anesthesia. Clear corneal incision was used with a 3.2 mm keratome. Sodium hyaluronate was injected to maintain the depth of the anterior chamber. Capsulorhexis completed using fine forceps. Hydro dissection was performed and the lens nucleus emulsified with Phaco machine using the stop and chop technique. The power used was 40-60%, a vacuum of 60-350 mmHg, and an aspiration flow rate of 25-30 ml/min. The bottle height raised to a maximum of 110 cm from a minimum of 90 cm during fragment removal. AbstractPurpose: We proposed to study the corneal endothelial change in correlation with corneal thickness after phacoemulsification with Intra Ocular Lens IOL implantation; comparing diabetics (long standing > 10 years) versus a control group of non-diabetics. These cataract patients were obtained from the Ophthalmology Clinic at Suez Canal University Hospital, Ismailia, Egypt. Aim:To determine how corneal endothelium in diabetic patients is affected by cataract surgery in comparison to age matched non-diabetics. This assessment will be made over the initial 1 month post-op period and will be determined (evaluated) by specular microscopy (model Nidek CEM 5301) as a primary report (Figure 1). Conclusion:Corneal endothelium in diabetic patients is more affected during the phacoemulsification for cataract extraction & IOL implantation surgery as evidenced in (one week) follow up post op. Comparison between pre-operat...

show abstract

Section: Corneal Endothelial Changes In Correlation With Corneal Thicmentioning

confidence: 99%

Corneal Endothelial Changes in Correlation with Corneal Thickness after Phacoemulsification among Diabetic Patients

Elbassiouny¹

2017

AOVS

View full text Add to dashboard Cite

show abstract

“…Although the irrigation and aspiration flow are necessary for the removal of the crystalline lens, they create circulation in the chamber, while the ultrasound wave induces acoustic streaming from the phacoemulsification tip, and this flow can damage the corneal endothelial cells (Hayashi et al 1996;O'Brien et al 2004;Topaz et al 2002;Miller et al 1996;Steinert and Schafer 2006;Polack and Sugar 1976;Binder et al 1976). Even hydrodynamic forces acting on the endothelial cells without sonification or rubbing of the nuclear materials are deleterious to the endothelium (Binder et al 1976).…”

Section: Introductionmentioning

confidence: 96%

“…Even hydrodynamic forces acting on the endothelial cells without sonification or rubbing of the nuclear materials are deleterious to the endothelium (Binder et al 1976). The tangential component of the hydrodynamic forces, i.e., shear stress, affects the endothelial cells such as vascular endothelial cells (Thoumine et al 1995), hybridomas (Born et al 1992), and even cornea endothelial cells (Kaji et al 2005).…”

Section: Introductionmentioning

confidence: 99%

Stereo-PIV study of flow inside an eye under cataract surgery

et al. 2011

View full text Add to dashboard Cite

We measured velocity distributions in the anterior chamber of porcine eyes under simulated cataract surgery using stereoscopic particle image velocimetry (stereo-PIV). The surface of the cornea was detected based on the images of laser-induced fluorescent light emitted from fluorescent dye solution introduced in a posterior chamber. A coaxial phacoemulsification procedure was simulated with standard size (standard coaxial phacoemulsification) and smaller (micro coaxial phacoemulsification) surgical instruments. In both cases, an asymmetric flow rate of irrigation was observed, although both irrigation ports had the same dimensions prior to insertion into the eye. In cases where the tip of the handpiece was placed farther away from the top of the cornea, i.e., closer to the crystalline lens, direct impingement of irrigation flow onto the cornea surface was avoided and the flow turned back toward the handpiece along the surface of the corneal endothelium. Viscous shear stress on the corneal endothelium was computed based on the measured mean velocity distribution. The maximum shear stress for most cases exceeded 0.1 Pa, which is comparable to the shear stress that caused detachment of the corneal endothelial cells reported by Kaji et al. in Cornea 24:S55-S58, (2005). When direct impingement of the irrigation flow was avoided, the shear stress was reduced considerably.

show abstract

“…Only histological studies in animals are available (Binder et al, 1976;Pollack & Sugar, 1976). Bourne & Kaufman (1976c) reported on 5 patients that underwent extracapsular surgery with IOL implantation by one of the authors (K).…”

Section: Evaluation Of the Amount Of Endothelial Trauma In Connectionmentioning

confidence: 99%