Safety and efficacy of hypertonic saline solution (5%) versus placebo in the treatment of postoperative corneal edema after uneventful phacoemulsification: a randomized double-blind study

Tzamalis, Argyrios; Dermenoudi, Maria; Diafas, Asterios; Oustoglou, Eirini; Matsou, Artemis; Ziakas, Nikolaos; Tsinopoulos, Ioannis

doi:10.1007/s10792-020-01395-4

Cited by 7 publications

(12 citation statements)

References 21 publications

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“…Tzamalis et al . [ 13 ] evaluated the safety and efficacy of hypertonic saline eye drops (5%) in post-operative corneal edema after phacoemulsification and found no statistically significant difference in BCVA, corneal edema score, central corneal thickness, and endothelial cell density in both the treatment and placebo group at 1 month of follow-up. Knezović et al .…”

Section: Discussionmentioning

confidence: 99%

Evaluation of striate keratopathy after manual small-incision cataract surgery and its final outcomes in a tertiary hospital

Rajappa

Bhatt

2022

Indian Journal of Ophthalmology

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Purpose: To study the demographic profile, contributing and precipitating factors, the severity of striate keratopathy and its relation with endothelial cell count, and evaluate the final treatment outcome of striate keratopathy. Methods: This observational analytical cohort study was conducted on 75 patients developing striate keratopathy after MSICS in the immediate postoperative period. Demographic profile, preoperative risk factors, and intraoperative complications were evaluated retrospectively. Postoperatively, slit-lamp grading of striate keratopathy was done, and specular microscopy of both eyes was taken. Treatment of striate keratopathy was initiated, and patients were followed up for 6 to 10 weeks for improvement. Results: Striate keratopathy was most commonly associated with surgeries performed by resident surgeons (92%), longer duration of surgery, associated predisposing factors, and intraoperative or postoperative complications. On postoperative day 1, the majority of patients had moderate and severe striate keratopathy (66% and 32%, respectively). It was associated with significant endothelial cell loss (ECL) at the final follow-up ( P = 0.0016). Striate keratopathy resolved in 97.3% of patients, irrespective of the treatment with hypertonic saline. At 6 to 10 weeks, 92% of patients achieved a BCVA of ≥6/9. Conclusion: A careful preoperative evaluation, adequate training of resident surgeons, meticulous surgical technique, and prompt management of postoperative complications can lead to a decrease in the incidence of striate keratopathy in the majority of cases. The use of hypertonic saline eye drops does not change the final outcome, and most cases resolve spontaneously during follow-up.

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Section: Discussionmentioning

confidence: 99%

Evaluation of striate keratopathy after manual small-incision cataract surgery and its final outcomes in a tertiary hospital

Rajappa

Bhatt

2022

Indian Journal of Ophthalmology

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“…In EDEMAS, one-half of the participants randomized to hyperosmolar eye drops reported prospectively recorded adverse events compared with placebo. However, we do not believe the study 5 referenced by Dr Hoffart on hyperosmolar eye drops in eyes with marked corneal edema after cataract surgery provides reliable evidence in favor or against the use of hyperosmolar eye drops. Although the study did not define its primary outcome, it is notable that only one of the many outcome measures and many timepoints showed was "statistically significant," raising the possibility of a chance finding.…”

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confidence: 82%

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Zander¹,

Reinhard²,

Wacker³

2022

Ophthalmology

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“…Both tissues play a role as a barrier and keep the stroma hydrated. The stroma is composed of collagen fibrils encased in regularly spaced glycosaminoglycans and mucopolysaccharides that tend to absorb fluid and swell [1,5,[14][15][16][17][18][19][20]. Epithelial and endothelial cells are intimately involved in regulating the circulation of fluids and electrolytes in the stroma [1,5,9,11,14,17,21,22].…”

Section: Introductionmentioning

confidence: 99%

“…Corneal edema can occur due to endothelial damage during surgery [5,7,15,29,30]. Endothelial decompensation during cataract surgery has been reported in the literature [20,24,26,[30][31][32][33]. However, some of the causes of corneal swelling are classified according to factors directly related to the patient (low endothelial cell density, cataract grade, shallow anterior chamber depth), to the surgical procedure (nucleus extraction method, effective power time of ultrasound for lens extraction, type of viscoelastic used, vitreous loss and rupture of the posterior capsule) [12,26,27,30,[32][33][34], or to intraocular lens implantation (chronic iritis, secondary glaucoma, peripheral anterior synechiae, intraocular lens subluxation) [31,32,35].…”

Section: Introductionmentioning

confidence: 99%

“…Finally, it is important to further investigate this corneal disease, as chronic or prolonged swelling processes may lead to bullous keratopathy (BK) or pseudophakic cystoid macular edema (PCME) [15,20,33,[35][36][37][38][39]. BK is an incurable disease primarily caused by endothelial decompensation, typically after surgery, mechanical stress, glaucoma, or diabetes mellitus, making keratoplasty the only treatment option to restore the patient's vision [15,31,[35][36][37]40].…”

Section: Introductionmentioning

confidence: 99%

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Corneal Edema after Cataract Surgery

Briceno-Lopez,

Burguera-Giménez,

García-Domene

et al. 2023

JCM

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This systematic review investigates the prevalence and underlying causes of corneal edema following cataract surgery employing manual phacoemulsification. A comprehensive search encompassing databases such as PubMed, Embase, ProQuest, Cochrane Library, and Scopus was conducted, focusing on variables encompassing cataract surgery and corneal edema. Two independent reviewers systematically extracted pertinent data from 103 articles, consisting of 62 theoretical studies and 41 clinical trials. These studies delved into various aspects related to corneal edema after cataract surgery, including endothelial cell loss, pachymetry measurements, visual performance, surgical techniques, supplies, medications, and assessments of endothelial and epithelial barriers. This review, encompassing an extensive analysis of 3060 records, revealed significant correlations between corneal edema and endothelial cell loss during phacoemulsification surgery. Factors such as patient age, cataract grade, and mechanical stress were identified as contributors to endothelial cell loss. Furthermore, pachymetry and optical coherence tomography emerged as valuable diagnostic tools for assessing corneal edema. In conclusion, this systematic review underscores the link between corneal edema and endothelial cell loss in manual phacoemulsification cataract surgery. It highlights the relevance of factors like patient demographics and diagnostic modalities. However, further research is essential to unravel the complexities of refractive changes and the underlying mechanisms.

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Safety and efficacy of hypertonic saline solution (5%) versus placebo in the treatment of postoperative corneal edema after uneventful phacoemulsification: a randomized double-blind study

Cited by 7 publications

References 21 publications

Evaluation of striate keratopathy after manual small-incision cataract surgery and its final outcomes in a tertiary hospital

Evaluation of striate keratopathy after manual small-incision cataract surgery and its final outcomes in a tertiary hospital

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Corneal Edema after Cataract Surgery

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