Corneal Endothelium Evaluation After Phacoemulsification With Continuous Anterior Chamber Infusion

Abstract

: The trend in modern cataract surgery is to reduce postoperative ocular trauma, and this can be achieved by small-incision phacoemulsification. But it requires a learning curve that we believe can be softened by using some surgical maneuvers such as continuous anterior chamber infusion, which minimizes the risk for anterior chamber collapse during the intervention. Comparing postoperative pachymetry and EC density between group 1 and 2, we found that the use of CACI does not add any additional damage to corneal structures because the initial statistically significant EC loss at day 7 postoperatively has a prompt recovery in subsequent visits, and then the EC loss remains similar in both groups. Transition from conventional to bimanual phacoemulsification can be simplified by using CACI, and it does not increase postoperative corneal damage.

Impact of high and low aspiration parameters on postoperative outcomes of phacoemulsification: Randomized clinical trial

“…[19][20][21] It has also been suggested that corneal thickness provides a measure of the amount of surgically induced endothelial injury. 22 Some suggest that an increase in CCT on the first postoperative day correlates with surgical trauma to the endothelium and that it is proportional to cell loss at 3 months. 23 In the present study, eyes having surgery with a low aspiration flow (Group 1) had a significantly lower rate of change in CCT postoperatively.…”

Corneal endothelial damage after cataract surgery: Microincision versus standard technique

“…The MICS technique may require longer surgical times at the beginning of the learning curve, and the use of continuous anterior chamber infusion and more manipulation inside the anterior chamber may cause endothelial damage. 18 On the other hand, MICS uses a smaller incision and incurs less tissue heating, probably due to decreased friction between the phacoemulsification probe sleeve and the phacoemulsification tip. 19,20 Standard phacoemulsification and MICS require a high degree of control over intraoperative ocular hydrodynamics.…”

Functional evaluation of corneal endothelium by combined measurement of corneal volume alteration and cell density after phacoemulsification

“…Several studies [8][9][10][11][12] have used specular microscopy to quantitatively assess the corneal damage associated with phacoemulsification by measuring the degree of decrease in the central corneal cell density. However, the measurement area in specular microscopy is small; thus, it may not be an appropriate method for evaluating damage to the entire cornea.…”