Effect of hydrodynamic parameters on corneal endothelial cell loss after phacoemulsification

Baradaran‐Rafii, Alireza; Rahmati-Kamel, Mohsen; Eslani, Medi; Kiavash, Victoria; Karimian, Farid

doi:10.1016/j.jcrs.2008.12.017

Cited by 71 publications

(63 citation statements)

References 24 publications

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“…Endothelial cell density decreases at a greater rate compared to unoperated eyes. ECL after cataract surgery varies in different studies, and ranges from 4 to 23 % after 3 months [13,11,[22][23][24][25][26][27][28]. A lot of authors evaluate ECL after 3 months or conclude that endothelial cell loss stabilized within this time [29,28,30,31,23].…”

Section: Discussionmentioning

confidence: 99%

Influence of anterior chamber depth, anterior chamber volume, axial length, and lens density on postoperative endothelial cell loss

Reuschel

Bogatsch

Oertel

et al. 2015

Graefes Arch Clin Exp Ophthalmol

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Section: Discussionmentioning

confidence: 99%

Influence of anterior chamber depth, anterior chamber volume, axial length, and lens density on postoperative endothelial cell loss

Reuschel

Bogatsch

Oertel

et al. 2015

Graefes Arch Clin Exp Ophthalmol

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“…The volume of fluid used has been implicated as a risk factor for corneal endothelial damage, because irrigation flow and turbulence within the anterior chamber may compromise the glycoprotein coat of the endothelium and induce stress (19) . Whether the increased risk for endothelial damage is related to fluidic principles or simply to the fact that volume infused is a surrogate measure of needle time is unclear (20) . Regarding study weakness, the first limitation of this study is surgeon bias.…”

Section: Discussionmentioning

confidence: 99%

Subconjunctival and topical application of recombinant tissue plasminogen activator in rabbits

Reggi¹,

Hida²,

Hida³

et al. 2015

Arquivos Brasileiros De Oftalmologia

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ClinicalTrials.gov Identifier: NCT02089698 ABSTRACTPurpose: To compare the efficiency of surgical procedures using three phaco tip designs in torsional phacoemulsification using the bevel-down technique. Methods: In this prospective, comparative, masked study, patients were randomly assigned to have torsional coaxial microincision cataract surgery using the mini-flared 45-degree Kelman tip, reversed mini-flared 30-degree Kelman tip, or Sidewinder 30-degree Kelman tip. Clinical measurements included preoperative and 3-month postoperative corrected distance visual acuity (CDVA), endothelial cell counts (ECC), and preoperative and 1-day postoperative central corneal thickness (CCT). Intraoperative measurements included phaco time, torsional time, aspiration time, case time, cumulative dissipated energy (CDE), and balanced salt solution volume (BSS). Results: The study evaluated 150 eyes of 150 patients. Intraoperatively, there was no statistically significant difference in cumulative dissipated energy, case time, torsional time, and aspiration time between the three tip configurations. However, less phaco time was used with the mini-flared 45-degree Kelman tip (p=0.02) than that with the Sidewinder 30-degree Kelman tip or reversed mini-flared 30-degree Kelman tip. The mini-flared 45-degree Kelman tip and the reversed mini-flared 30-degree Kelman tip required significantly less balanced salt solution volume than that required by the Sidewinder 30-degree Kelman tip (p=0.009). There was no statistically significant difference in corrected distance visual acuity and endothelial cell counts between tips 3 months postoperatively (p>0.05). Conclusion: All three tips were effective with no intraoperative complications. When using torsional phacoemulsification through microincisions and the prefractu re technique with the bevel-down technique, the mini-flared 45-degree Kelman tip required a lower mean phaco time than the reversed mini-flared 30-degree Kelman tip and the Sidewinder 30-degree Kelman tip.

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“…Hayashi et al 19 found that nuclear fragments that have mechanical contact with the endothelium are the significant risk factors for intraoperative endothelial injury. Furthermore, they found that the total amount of ultrasound energy and hydrodynamic flow in the anterior chamber might be related to corneal endothelial cell 14 evaluated the effects of power, vacuum settings, and flow rates on endothelial cell loss after phacoemulsification and found that ultrasound energy had a considerable effect on endothelial cell loss. Therefore, techniques and parameters that safely allow posterior-plane emulsification would likely reduce corneal endothelial injury.…”

Section: Discussionmentioning

confidence: 99%

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

Vasavada¹,

Praveen²,

Vasavada³

et al. 2010

Journal of Cataract and Refractive Surgery

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Effect of hydrodynamic parameters on corneal endothelial cell loss after phacoemulsification

Abstract: Vacuum level did not have a significant effect on total US energy or total fluid consumed during phacoemulsification. There was a strong relationship between total US energy and endothelial cell loss but not between total infused fluid and endothelial cell loss.

Cited by 71 publications

References 24 publications

Influence of anterior chamber depth, anterior chamber volume, axial length, and lens density on postoperative endothelial cell loss

Influence of anterior chamber depth, anterior chamber volume, axial length, and lens density on postoperative endothelial cell loss

Subconjunctival and topical application of recombinant tissue plasminogen activator in rabbits

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

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