Evaluation of corneal endothelial cell loss in different grades of nucleus during phacoemulsification

Mehra, Priyanka; Verma, Rajendra Kumar

doi:10.17511/ijmrr.2015.i10.204

Cited by 4 publications

(8 citation statements)

References 12 publications

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“…This is similar to current study results (5.7% in group A, 10.2% in group B) and (6.5% in group A, 11.5% in group B) one week and two months postoperative respectively. Also, Mehra and Verma [16] show with nucleus opalescence grade 3 endothelial cell loss at day 1, 1 week and 6week 357.96 cells/mm 2 (14.18%), 395.27 cells/mm 2 (15.65%) and 424.88 cells/mm 2 (16.83%) respectively and Reuschel et al, [10] show endothelial cell loss of 5.2% (range 1.7%-7.6%) 3 month postoperative. This may show some difference and may be attributed to variation in the patient selection criteria and the technique and technology used in the phaco surgery.…”

Section: Discussionmentioning

confidence: 97%

“…Corneal endothelial cells are not regenerated once they are damaged [11] and had a pump function which keep Cornea transparent, this pump can be affected by surgical trauma [15] . Thus, endothelial cell loss should be assisted because one of the common complication of cataract surgery was corneal decompensation [16] .…”

Section: Discussionmentioning

confidence: 99%

“…Thus, such technique is the better for study the anterior chamber depth (ACD) influence on the endothelial cell loss [11] , which was done in this study. Also, an expert surgeon with sufficient phacoemulsification surgical skills was essential in standardizing the operative results [16] and so, all surgeries done by the same surgeon with expert skills.…”

Section: Discussionmentioning

confidence: 99%

“…Also in the current study preoperative endothelial cell count (ECC) (2615.0 ±272.0 in group A and 2292.4±201.1 in group B) was comparable with other studies eg. Reuschel et al, [10] ECC was 2401 [2321-2511], [16] ECC was (2524.94), [11] ECC was 2658. 20, 2646.27, 2602.47 in three different anterior chamber depths, but show some significant statistical difference between the two groups (this may partial coinside with the significant statistical difference in age between them and also may be related to small sample size).…”

Section: Discussionmentioning

confidence: 99%

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Endothelial Cell Loss after Phacoemulsification According to Different Anterior Chamber Depths in Hard Cataract

BADRAN¹,

EL-MONIEM

2022

The Medical Journal of Cairo University

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Background: Phacoemulsification which is performed through a limited space (anterior chamber of the eye) carries the risk of endothelial cell loss (ECL). So, the aim of this study was to compare the loss of corneal endothelial cells after phacoemulsification according to different anterior chamber depths in hard cataract. Aim of Study:Compare the loss of corneal endothelial cells after phacoemulsification according to different anterior chamber depths. Differences in cumulative dissipated energy, Endothelial cell loss among the anterior chamber depth groups.Patients and Methods: Prospective study on 30 eyes of 25 patients with senile cataract of nuclear opalescence grade 3 (NO3) divided into 2 groups according to anterior chamber depth: group A >2.99mm & group B < OR=2.99mm. intraoperative mean cumulative dissipated energy (MCDE) and the used irrigation solution volume were measured. Clinical examination and investigation include Best Corrected Distance Visual Acuity and Endothelial cell count (ECC) that measured preoperative, one week and 2 months postoperative. Results:No statistical significant difference between the two groups in MCDE and irrigation solution volume. Preoperative ECC was statistical significant higher in group A than B and become highly statistical significant higher in group A than B 1 week and 2 months postoperative. ECL was statistical significant higher in group B than A 1 week and 2 months postoperative. In each group there was high statistical significant improvement in best corrected visual acquity 1 week and 2 month postoperative. Conclusion:The current study concluded that shallow anterior chamber depth is a risk factor for endothelial cell loss in hard cataract (NO3) in phacoemulsification cataract surgery. So, surgeons should pay more care in patient with shallow anterior chamber depth with hard cataract densities.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Endothelial Cell Loss after Phacoemulsification According to Different Anterior Chamber Depths in Hard Cataract

BADRAN¹,

EL-MONIEM

2022

The Medical Journal of Cairo University

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“…According to study done by Mehra et al endothelial cell loss is also depending on grading of nuclear sclerosis at the time of surgery [18].…”

Section: Central Corneal Thicknessmentioning

confidence: 99%

Comparison of Morphological and Functional Corneal Endothelial Changes after Cataract Surgery under DBCS Program at a Tertiary Care Centre

Gupta¹,

Bh²,

Shedole³

2020

J Clin Exp Ophthal

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Introduction: Cataract extraction constitutes the largest workload through DBCS program in ophthalmic units in India. Both SICS & Phacoemulsification surgery are performed in a limited, confined space; however, securing adequate surgical space during cataract surgery can decrease the risk of corneal endothelial cell loss.1 Thus, anatomical and surgical factors, such as adequate Anterior Chamber Depth (ACD), are important for preserving these cells from the mechanical and thermal damage that can occur during the procedure. Under normal circumstances, corneal endothelial cells do not proliferate because they are stuck in G1 phase of cell cycle. The central corneal endothelial cell density gradually decreases at an average of about 0.6% per year, reducing approximately from 3400 cells/mm 2 at age 15 to 2300 cells at age 80 years. Two important factors in maintaining corneal transparency are the number and the integrity of the corneal endothelial cells.3 Corneas with cell densities as low as 500 cells/mm 2 and average cell area of approximately 2000-3000 µm 2 can remain clear. Protection of corneal endothelium during cataract surgery is critical for achieving good visual outcomes. Objectives: To study the endothelial cell loss in SICS and Phacoemulsification and compare the cell loss between two surgeries and to compare morphological and functional changes in corneal endothelium between the two surgeries. Materials and methods: A comparative prospective study is performed in 200 eyes of 200 patients attending DBCS Camp at Babuji Eye Hospital and Chigateri General Hospital attached to JJM Medical College Hospital, Davanagere from July 2018 to October 2019 for cataract surgery. Patients were randomly allocated to two groups. One group underwent small incision cataract surgery and the other group underwent phacoemulsification. Corneal endothelial assessment was done for patients undergoing both the surgeries using non-contact specular microscopy Tomey EM 3000 preoperatively and postoperatively at 1 week and 6 weeks. Results: In SICS group, corneal endothelial count was 2303.0 ± 329.1 preoperatively, postoperatively it was reduced to 2068.9 ± 381.1 at 1 week and 1980.3 ± 401.5 at 6 weeks. In phacoemulsification group, it was found to be 2213.9 ± 442.3 preoperatively and which reduced to 1878.7 ± 458.3 at 1 week and 1796.4 ± 467.3 at 6 weeks postoperatively. Cases in SICS group showed 10.2% loss at 1 week and 14% cell loss at 6 weeks while phacoemulsification group showed 15.1% cell loss at 1 week and 18.9% cell loss at 6 weeks. Polymegathism was increased in both the groups while hexagonality was decreased in both groups. No significant difference in functional parameters like central corneal thickness (CCT) and best corrected visual acuity (BCVA) was observed in both SICS and Phacoemulsification group at the end of 6 weeks.

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Narrative review after post-hoc trial analysis of factors that predict corneal endothelial cell loss after phacoemulsification: Tips for improving cataract surgery research

Perone,

Luc,

Zevering

et al. 2024

PLoS ONE

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Purpose Identifying pre/perioperative factors that predict corneal endothelial-cell loss (ECL) after phacoemulsification may reveal ways to reduce ECL. Our literature analysis showed that 37 studies have investigated one or several such factors but all have significant limitations. Therefore, the data of a large randomized controlled trial (PERCEPOLIS) were subjected to post-hoc multivariate analysis determining the ability of nine pre/perioperative variables to predict ECL. Methods PERCEPOLIS was conducted in 2015–2016 to compare two phacoemulsification techniques (subluxation and divide-and-conquer) in terms of 3-month ECL. Non-inferiority between the techniques was found. In the present study, post-hoc univariate and multivariate analyses were conducted to determine associations between ECL and age, sex, cataract density, preoperative endothelial-cell density, phacoemulsification technique, effective phaco time (EPT), and 2-hour central-corneal thickness. The data are presented in the context of a narrative review of the literature. Results Three-month data were available for 275 patients (94% of the randomized cohort; mean age, 74 years; 58% women). Mean LOCSIII cataract grade was 3.2. Mean EPT was 6 seconds. Mean ECL was 13%. Only an older age (beta = 0.2%, p = 0.049) and higher EPT (beta = 1.2%, p = 0.0002) predicted 3-month ECL. Cataract density was significant on univariate (p = 0.04) but not multivariate analysis. The other variables did not associate with ECL. Conclusions Older age may amplify ECL due to increased endothelial cell fragility. EPT may promote ECL via cataract density-dependent and -independent mechanisms that should be considered in future phacoemulsification research aiming to reduce ECL. Our literature analysis showed that the average ECL for relatively unselected consecutively-sampled cohorts is 12%.

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Evaluation of corneal endothelial cell loss in different grades of nucleus during phacoemulsification

Cited by 4 publications

References 12 publications

Endothelial Cell Loss after Phacoemulsification According to Different Anterior Chamber Depths in Hard Cataract

Endothelial Cell Loss after Phacoemulsification According to Different Anterior Chamber Depths in Hard Cataract

Comparison of Morphological and Functional Corneal Endothelial Changes after Cataract Surgery under DBCS Program at a Tertiary Care Centre

Narrative review after post-hoc trial analysis of factors that predict corneal endothelial cell loss after phacoemulsification: Tips for improving cataract surgery research

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