Effect of Reformation of the Anterior Chamber by Air or by Ringer’s lactate solution on Corneal Endothelial count and morphology after Phacoemulsification

Abstract

The corneal endothelium has no ability of regeneration, so any decrease in its density is irreversible and can lead to permanent blurring of vision and pain. Direct contact between air and the corneal endothelium may cause endothelial damage. Aim: To compare the effect of reformation of the anterior chamber after phacoemulsification, using air and ringer's lactate solution injection, on corneal endothelial count and morphology. Methods: A prospective interventional randomized comparative study includes 76 eyes of 76 patients, prepared for phacoemulsification surgery in the period from October 2018 to March 2019. Corneal endothelial morphology and count examined by specular microscopy, and the results recorded for all cases before the surgery. Patients examined by slit lamp biomicroscope and divided randomly into two groups, and both groups were diagnosed with grade 1-2 age related cataract. Both groups underwent phacoemulsification surgery with IOL implantation by single well-trained surgeon, group 1 will be subjected to anterior chamber reformation with 0.1 ml air injection while group 2 will be subjected to reformation of the anterior chamber with ringer's lactate solution. Corneal endothelial count and morphology to be evaluated at 1 week, 1 month and 3 months postoperatively. Results: no significant statistical difference regarding the percentage of CCT changes, cell loss, coefficient of variation and hexagonality between the two groups at baseline and all subsequent visits. Conclusion: no significant difference between air and ringer's lactate solution on the corneal endothelial count or morphology.