Change in central corneal thickness, corneal endothelial cell density, anterior chamber depth and axial length after repair of rhegmatogenous retinal detachment

Abstract

Objective:To compare the effects of Pars Plana Vitrectomy (PPV) and Scleral Buckling (SB) with reference to Central Corneal Thickness (CCT), Corneal Endothelial-Cell Density (CED), Anterior Chamber Depth (ACD) and Axial Length (AL) in repair of Rhegmatogenous Retinal Detachment (RRD).Methods:This comparative cross sectional analytical study was conducted at Armed Forces Institute of Ophthalmology (AFIO), Rawalpindi from July 2013 to July 2015. A total of 69 eyes of 69 patients which underwent repair of RRD by either PPV or SB were analyzed to compare mean change in CCT, CED, ACD and AL between two groups.Results:Mean age of patients was 56.23±5.22 years. Mean pre-operative CCT, CED, ACD and AL in PPV group was 533.06±13.28µm, 2231.67±164.57Cells/mm2, 3.37±0.18mm and 23.66±0.76mm respectively. Mean post-operative CCT, CED, ACD and AL in PPV group was 534.81±11.83µm, 2037.19±167.83 Cells/mm2, 3.24±0.13mm and 23.88±0.80mm respectively. Change in CED, ACD and AL from pre-operative value after PPV was statistically significant (p<0.001). Mean pre-operative CCT, CED, ACD and AL in SB group was 530.73±12.59 µm, 2161.79±161.96 Cells/mm2, 3.343±0.14mm and 23.67±0.82mm respectively. Mean post-operative CCT, CED, ACD and AL in SB group was 532.76±7.74 µm, 2158.27±156.58 Cells/mm2, 3.24±0.10mmand 25.71±0.86mm respectively. Change in ACD and AL from pre-operative value after SB was statistically significant (p<0.001). Mean change of CED, ACD and AL between two groups was also statistically significant (p<0.001).Conclusion:Rhegmatogenous retinal detachment repair causes ocular changes, with significantly more decrease in corneal endothelial cell density after pars plana vitrectomy, and more increase in anterior chamber depth and axial length after scleral buckling.

Changes in ocular biometric measurements after vitrectomy with silicone oil tamponade for rhegmatogenous retinal detachment repair

“…Using the IOLMaster 700, which provides a 44-mm scan depth, captures 2000 A-scans per second for the full-eye length tomogram acquisition and shows anatomical details of a longitudinal cut through the entire eye [ 15 ], we observed an underestimation of AL in eyes with macula-off RRD. Furthermore, ACD of RRD eyes was also decreased by an average of 0.14 mm after vitrectomy, consistent with previous studies [ 23 ]. Huang et al attributed this phenomenon to abnormally low intraocular pressure prior to surgery, which results in falsely high measurements of ACD, postoperatively recovered intraocular pressure, and an operative wound, which stimulates contraction of the ciliary body muscle to induce increased lens convexity and LT [ 9 ].…”

Changes in corneal endothelial density following scleral buckling surgery for rhegmatogenous retinal detachment: a retrospective cross-sectional study

“…In the current study, a significant HCEC loss of 407 by 14.46% loss ( P < 0.001) was found in the study group compared to that in the control group and the ECD number was also significant difference between the study group and the contralateral group, which was contradictory to what was reported recently [23]. Moreover, the significantly enlarged cell area in the study group further demonstrated that the quantity of HCEC was impaired after the SB.…”

“…The decrement of ECD concerning percentage is similar to the HCEC loss in cataract and corneal transplantation surgeries with normal ECD and a follow up period from one month to 20 years, which might lead to corneal decompensation in some cases [34–37]. A possible explanation for the conflicting outcomes between the current study and the other by Mukhtar et al is that the latter excluded various common ocular disorders which might damage the corneal endothelium [23]. The average ECD in the study group was above 2400/mm 2 thus the development of corneal decompensation in our patients was less likely.…”

“…Specifically, we speculate that the effect of SB to HCEC is an acute damage rather than a chronic influence. In previous reports that evaluated the alteration of anterior segment after retinal surgery including SB, the change of anterior segment were mostly observed within one year [23, 27, 29]. In addition, the anterior chamber depth and central cornea thickness had no correlation to the interval after SB in the study written by Huang et al [27].…”

“…Nevertheless, the sole effect of SB on HCEC remains not fully elucidated because only one study revealed a non-significant decrement of HCEC after SB which did not separate the two subtypes of SB, i.e. encircling and segmental intervention, within the analyses [23].…”