Long-term Corneal Endothelial Cell Loss After Cataract Surgery

Sutured Scleral-Fixated Versus Anterior Chamber Intraocular Lens Implantation: A Meta-Analysis

“…3,5,12,13,[16][17][18] Our main analysis likely did not demonstrate a significant difference in corneal edema, which is a wellknown ACIOL complication, because the follow-up period was too short to capture cases of corneal edema that may occur after several years owing to gradual endothelial cell loss. 16,19 The analysis with concurrent PPV showed significantly higher corneal edema incidence in ACIOL implantation than in SSFIOL implantation. This was based on two studies, 5,15 only one of which individually reported a significant difference.…”

“…Endothelial cell loss can become a serious adverse effect of IOL implantation, resulting in corneal edema, uveitis, IOL decentration/subluxation, and CME. 19 Endothelial cell loss during surgery should be minimized because the corneal endothelium has a limited ability to regenerate following surgical trauma and toxicity from inflammatory mediators. 20,21 A meta-analysis could not be conducted for this outcome because only one study reported on this endpoint.…”

Sutured Scleral-Fixated Versus Anterior Chamber Intraocular Lens Implantation: A Meta-Analysis

“…3,5,12,13,[16][17][18] Our main analysis likely did not demonstrate a significant difference in corneal edema, which is a wellknown ACIOL complication, because the follow-up period was too short to capture cases of corneal edema that may occur after several years owing to gradual endothelial cell loss. 16,19 The analysis with concurrent PPV showed significantly higher corneal edema incidence in ACIOL implantation than in SSFIOL implantation. This was based on two studies, 5,15 only one of which individually reported a significant difference.…”

“…Endothelial cell loss can become a serious adverse effect of IOL implantation, resulting in corneal edema, uveitis, IOL decentration/subluxation, and CME. 19 Endothelial cell loss during surgery should be minimized because the corneal endothelium has a limited ability to regenerate following surgical trauma and toxicity from inflammatory mediators. 20,21 A meta-analysis could not be conducted for this outcome because only one study reported on this endpoint.…”

Balanced Salt Solution Assisted Intraocular Lens Implantation in Phacoemulsification Surgery: Intraocular Pressure and Endothelial Study

“…Moreover, prolonged I/A to completely remove the injected viscoelastic for IOL implantation increases the operation time and fluid flow, and thus might affect CEC characteristics (13,14). Furthermore, OVD remaining in the eye may induce IOP spikes and inflammation immediately after cataract surgery, which may cause further CEC damage (7,17), In light of this information, the present study compared changes in CECs using BSS-assisted IOL implantation with the standard method using OVDs during IOL implantation. The results demonstrated that at the end of the third month, the endothelial loss was 8.9% in Group 1 and 8.4% in Group 2.…”

“…Furthermore, OVDs may reduce wrinkling of the cornea and mechanical stress on the CECs during implantation of the IOL with injector system (13). In contrast, it has been reported that OVDs increased thermal damage, causing CEC loss (7), for which the possible explanation is that if there is no flow of fluid around the phaco tip as a result of the viscoelastic substance, the phaco tip temperature may increase and burn the cornea, damaging CECs (14). Moreover, prolonged I/A to completely remove the injected viscoelastic for IOL implantation increases the operation time and fluid flow, and thus might affect CEC characteristics (13,14).…”

“…IOP spikes could worsen damage in the fiber layer of the retinal nerve and visual field loss in patients with glaucoma (6). OVDs may also cause inflammation immediately after cataract surgery (7), and if the OVD behind the IOL is not removed completely, it may lead to capsular disten-sion syndrome (8). To prevent this complication, careful OVD removal should be performed, though this may prolong the surgical time, which may be associated with further endothelial cell loss (9).…”

Sutured Scleral-Fixated Versus Anterior Chamber Intraocular Lens Implantation: A Meta-Analysis

“…3,5,12,13,[16][17][18] Our main analysis likely did not demonstrate a significant difference in corneal edema, which is a wellknown ACIOL complication, because the follow-up period was too short to capture cases of corneal edema that may occur after several years owing to gradual endothelial cell loss. 16,19 The analysis with concurrent PPV showed significantly higher corneal edema incidence in ACIOL implantation than in SSFIOL implantation. This was based on two studies, 5,15 only one of which individually reported a significant difference.…”

“…Endothelial cell loss can become a serious adverse effect of IOL implantation, resulting in corneal edema, uveitis, IOL decentration/subluxation, and CME. 19 Endothelial cell loss during surgery should be minimized because the corneal endothelium has a limited ability to regenerate following surgical trauma and toxicity from inflammatory mediators. 20,21 A meta-analysis could not be conducted for this outcome because only one study reported on this endpoint.…”

Balanced Salt Solution Assisted Intraocular Lens Implantation in Phacoemulsification Surgery: Intraocular Pressure and Endothelial Study

“…Moreover, prolonged I/A to completely remove the injected viscoelastic for IOL implantation increases the operation time and fluid flow, and thus might affect CEC characteristics (13,14). Furthermore, OVD remaining in the eye may induce IOP spikes and inflammation immediately after cataract surgery, which may cause further CEC damage (7,17), In light of this information, the present study compared changes in CECs using BSS-assisted IOL implantation with the standard method using OVDs during IOL implantation. The results demonstrated that at the end of the third month, the endothelial loss was 8.9% in Group 1 and 8.4% in Group 2.…”

“…Furthermore, OVDs may reduce wrinkling of the cornea and mechanical stress on the CECs during implantation of the IOL with injector system (13). In contrast, it has been reported that OVDs increased thermal damage, causing CEC loss (7), for which the possible explanation is that if there is no flow of fluid around the phaco tip as a result of the viscoelastic substance, the phaco tip temperature may increase and burn the cornea, damaging CECs (14). Moreover, prolonged I/A to completely remove the injected viscoelastic for IOL implantation increases the operation time and fluid flow, and thus might affect CEC characteristics (13,14).…”

“…IOP spikes could worsen damage in the fiber layer of the retinal nerve and visual field loss in patients with glaucoma (6). OVDs may also cause inflammation immediately after cataract surgery (7), and if the OVD behind the IOL is not removed completely, it may lead to capsular disten-sion syndrome (8). To prevent this complication, careful OVD removal should be performed, though this may prolong the surgical time, which may be associated with further endothelial cell loss (9).…”

Sutured Scleral-Fixated Versus Anterior Chamber Intraocular Lens Implantation: A Meta-Analysis

“…3,5,12,13,[16][17][18] Our main analysis likely did not demonstrate a significant difference in corneal edema, which is a wellknown ACIOL complication, because the follow-up period was too short to capture cases of corneal edema that may occur after several years owing to gradual endothelial cell loss. 16,19 The analysis with concurrent PPV showed significantly higher corneal edema incidence in ACIOL implantation than in SSFIOL implantation. This was based on two studies, 5,15 only one of which individually reported a significant difference.…”

“…Endothelial cell loss can become a serious adverse effect of IOL implantation, resulting in corneal edema, uveitis, IOL decentration/subluxation, and CME. 19 Endothelial cell loss during surgery should be minimized because the corneal endothelium has a limited ability to regenerate following surgical trauma and toxicity from inflammatory mediators. 20,21 A meta-analysis could not be conducted for this outcome because only one study reported on this endpoint.…”

Balanced Salt Solution Assisted Intraocular Lens Implantation in Phacoemulsification Surgery: Intraocular Pressure and Endothelial Study

“…Moreover, prolonged I/A to completely remove the injected viscoelastic for IOL implantation increases the operation time and fluid flow, and thus might affect CEC characteristics (13,14). Furthermore, OVD remaining in the eye may induce IOP spikes and inflammation immediately after cataract surgery, which may cause further CEC damage (7,17), In light of this information, the present study compared changes in CECs using BSS-assisted IOL implantation with the standard method using OVDs during IOL implantation. The results demonstrated that at the end of the third month, the endothelial loss was 8.9% in Group 1 and 8.4% in Group 2.…”

“…Furthermore, OVDs may reduce wrinkling of the cornea and mechanical stress on the CECs during implantation of the IOL with injector system (13). In contrast, it has been reported that OVDs increased thermal damage, causing CEC loss (7), for which the possible explanation is that if there is no flow of fluid around the phaco tip as a result of the viscoelastic substance, the phaco tip temperature may increase and burn the cornea, damaging CECs (14). Moreover, prolonged I/A to completely remove the injected viscoelastic for IOL implantation increases the operation time and fluid flow, and thus might affect CEC characteristics (13,14).…”

“…IOP spikes could worsen damage in the fiber layer of the retinal nerve and visual field loss in patients with glaucoma (6). OVDs may also cause inflammation immediately after cataract surgery (7), and if the OVD behind the IOL is not removed completely, it may lead to capsular disten-sion syndrome (8). To prevent this complication, careful OVD removal should be performed, though this may prolong the surgical time, which may be associated with further endothelial cell loss (9).…”