Effect of cataract surgery on the corneal endothelium*1Modern phacoemulsification compared with extracapsular cataract surgery

Bourne, Rupert; Minassian, Darwin; Dart, John; Rosen, Paul; Kaushal, Sundeep; Wingate, Nicholas

doi:10.1016/j.ophtha.2003.07.015

Cited by 294 publications

(228 citation statements)

References 34 publications

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“…They did not perform regional specular microscopy in the area of the tube. In our study, we found a mean endothelial cell loss of approximatively 8% for the central and peripheral cornea during a 6-month period after surgery, which is higher than the reported age-related endothelial cell loss, 15 but comparable or even less to that following cataract extraction 16,17 or other glaucoma filtering procedures. 6,7,18 Smith et al 6 calculated a mean central endothelial cell loss ranging from 1.6 to 54.8% three months after glaucoma surgery, correlated with postoperative AC depth and intraoperative corneal touch.…”

Section: Discussioncontrasting

confidence: 60%

Coupling of HRT II and AS-OCT to evaluate corneal endothelial cell loss and in vivo visualization of the Ahmed glaucoma valve implant

Mendrinos

Dosso

Sommerhalder

et al. 2008

Eye

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Section: Discussioncontrasting

confidence: 60%

Coupling of HRT II and AS-OCT to evaluate corneal endothelial cell loss and in vivo visualization of the Ahmed glaucoma valve implant

Mendrinos

Dosso

Sommerhalder

et al. 2008

Eye

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“…These results are in good correlation with other authors' data. 3,5 We found similar ECL in the fluid-based and the ultrasound groups. The coefficient of variation in cell size was also similar in the two groups after surgery.…”

Section: Discussionsupporting

confidence: 55%

“…It is known that less surgical trauma causes lower endothelial damage. 2 ECL can occur during phacoemulsification from many causes such as hard and [4][5][6][7][25][26][27] Besides the above-mentioned parameters, the skill of the surgeon is still crucial.…”

Section: Discussionmentioning

confidence: 99%

“…The results on mean ECL vary from 0.4 to 27.7% after phacoemulsification, depending on different surgical techniques. 2,[4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] In recent years, new surgical procedures have been developed to reduce ECL, such as laserand fluid-based methods. During the latter procedure, short pulses (4 ml) of warmed balanced salt solution liquefy the lens material, while the irrigation fluid surrounds the warmed pulsating fluid allowing cooling of the pulse.…”

Section: Introductionmentioning

confidence: 99%

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Corneal endothelial function after phacoemulsification using the fluid-based system compared to conventional ultrasound technique

Tsorbatzoglou

Kertész

Módis

et al. 2006

Eye

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Aim To quantitatively assess corneal endothelial changes after phacoemulsification with the fluid-based system compared to conventional ultrasound technique. Methods This prospective, randomized clinical study included patients with cataract who were randomly assigned either to have phacoemulsification with the fluid-based system (30 eyes of 30 patientsFGroup 1) or with traditional ultrasound (30 eyes of 30 patientsFGroup 2). Patients who were available at each follow-up visit (25 eyes in both groups) were enrolled in the statistical analysis. Endothelial function was evaluated by measuring central corneal thickness, central endothelial cell density (ECD), mean cell size, and coefficient of variation in cell size preoperatively, 10 days, 1 and 3 months, and 1 year after surgery. Statistical analyses were performed using two-way repeated measure ANOVA. Results An acute, reversible increase of central corneal thickness (CCT) was found 10 days after surgery, which was similar in both groups (P ¼ 0.35). ECD decreased, whereas mean cell size increased significantly immediately after surgery. However, the impairments were finished after 1 month. The alterations were similar in both groups (ECD: P ¼ 0.99; mean cell size: P ¼ 0.85). The coefficient of variation in cell size remained stable after surgery (P ¼ 0.08), and significant difference was not found between groups (P ¼ 0.99). The endothelial cell loss (ECL) was 6.578.4% in Group 1 and 6.5711.7% in Group 2 (P ¼ 0.69). Conclusions Corneal endothelial changes were similar using the fluid-based system compared to the traditional ultrasound technique. The fluid-based method proved to be as safe as conventional ultrasound in cataract surgery.

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“…We have found Aqualase to be very Surgical and visual acuity outcomes were good, and the high percentage of clear corneas on the first postoperative day would suggest that the procedure is well tolerated by the corneal endothelium. No published data are available pertaining to endothelial cell loss after Aqualase so it is unknown how the method compares in this regard to phacoemulsification, which is known to result in a significant detrimental effect, 9 and we are in the process of studying this issue.…”

Section: Discussionmentioning

confidence: 99%

Aqualase for cataract extraction

Hughes

Mellington

Whitefield

2005

Eye

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Purpose To report our experience of using Aqualase technology for cataract extraction. Methods In total, 33 patients (20 females; mean age 71.4 years) underwent cataract surgery using Aqualase through a 3.2-mm corneal incision. Grade of nucleus, nuclear removal technique, and intraoperative complications were noted. Clinical parameters from postoperative visits were collected. Results Aqualase is capable of removing cataracts up to nuclear sclerosis 2 þ (out of 4) with relative ease. Nuclei graded 2 þ or greater were technically more difficult and conversion to ultrasound phacoemulsification was required in one case. Two posterior capsule ruptures occurred: one during nucleus removal (contact with the tip while aspirating without Aqualase) and one unrelated to Aqualase during aspiration of cortex. Of 25 patients seen on the first postoperative day, 22 had a clear cornea. A total of 96% patients without preoperative comorbidity achieved 6/9 or better postoperatively. One patient had transient postoperative uveitis. Conclusions Removal of softer cataracts with Aqualase has the theoretical advantage over phacoemulsification, by carrying less risk to the posterior capsule, since the handpiece has a smooth polymer tip that has no mechanical motion inside the eye. However, the tip should not be considered entirely capsule-friendly, as rupture is possible with the foot-pedal in position two (aspiration only). Although certain adjustments to the technique are required, the method is similar enough to phacoemulsification to ensure a brief learning curve. With increasingly firm cataracts, Aqualase becomes less effective and ultrasound phacoemulsification is still superior for such cases, in our experience.

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Effect of cataract surgery on the corneal endothelium*1Modern phacoemulsification compared with extracapsular cataract surgery

Cited by 294 publications

References 34 publications

Coupling of HRT II and AS-OCT to evaluate corneal endothelial cell loss and in vivo visualization of the Ahmed glaucoma valve implant

Coupling of HRT II and AS-OCT to evaluate corneal endothelial cell loss and in vivo visualization of the Ahmed glaucoma valve implant

Corneal endothelial function after phacoemulsification using the fluid-based system compared to conventional ultrasound technique

Aqualase for cataract extraction

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