Endothelial cells loss to the hyperopic pacients during phacoemulsification

Abstract

Introduction: The phacoemulsification cataract surgery is the most frequently performed surgery and it generally improves vision in over 90% of the patients. Hyperopic patients are a challenge during phacoemulsification especially because of their short eyeball and shallow anterior chamber. A shallow anterior chamber is associated with overall reduction of the safe zone, which may lead to difficulty in creating the corneal incisions, harder capsulorhexis performing, or endothelial complications. Purpose: The aim of the study was to present the endothelial cells loss after the phacoemulsification procedure in the hyperopic patients.Material and Methods: A number of 1775 patients operated in the Ophthalmology Department of the Clinical Hospital Sibiu from January 11, 2011 to December 20, 2013 have been included in our study; 595 cases with emmetropia and the rest of the 1180 patients had the following refraction errors: 216 - myopia and 964 - hypermetropia. From the total cases of the hypermetropia, we selected 72 patients to measure the endothelial cells density and the corneal thickness by using specular microscopy, one day before and 7-14 days after surgery.Results and discussions: The preexisting hypermetropia might modify the intraoperative and postoperative cataract surgery evolution. Endothelial cell loss is potentially higher from surgical trauma so that the endothelium must be protected with viscoelastics. The loss of endothelial cells in hyperopic eyes occurred with an average of 267 cell/ mm² and the thickness of the cornea increased by 13 µm.Conclusion: The phacoemulsification surgery in the presence of hypermetropia requires more attention. The biometry and the specular microscopy are very important tasks for the preoperative assessment, surgery, and postoperative care. The protection of the corneal endothelium with viscoelastics leads to an insignificant modification of the endothelial cells in hyperopic patients compared to an anterior study of the patients with all ametropies.

Microbe‐Mediated Extracellular and Intracellular Mineralization: Environmental, Industrial, and Biotechnological Applications

“…[ 83 ] Another advantage of yeast is its ability to differentiate between different metals such as selenium, antimony, and mercury based on their toxicity. Because of its cost effectiveness, [ 84 ] yeast has been applied for biosorption of toxic metal ions including uranium, [ 85,86 ] chromium, [ 87 ] cadium, and lead. [ 81 ]…”

“…The first step in biosorption involves attachment of metal ions to the cell surface through complexation with cell‐surface functional groups. [ 84 ] Another explanation for precipitation on cell surfaces is the presence of acid phosphatases, which meditate decomposition of organic phosphates and subsequent accumulation of lead on the cell surface. The second step in biosorption involves metal binding.…”

“…The method is cost‐efficient because of its potential for reuse and recovery. [ 84 ] 2)Installation of anionic functional groups: Installing phosphate functional groups on yeast cells provides them with negative charges that enhance the effectiveness of biosorption. With more negative charges, phosphorylated yeast cells can absorb heavy‐metal ions such as Cd 2+ , Cu 2+ , Pb 2+ , and Zn 2+ more effectively.…”

“…Fungi may also be used for the precipitation of metal‐containing carbonates and phosphates; they provide a new method of metal biorecovery and purification, including Cu 2+ , Sr 2+ , Pb 2+ , As 3+ , U 6+ , and Cr 6+ [ 71,79,260 ] As described previously, yeasts have been investigated extensively for bioremediation of heavy‐metal ions. [ 83–94 ] An example of the use of S. cerevisiae for the biomineralization of uranium (VI) is illustrated in Figure . [ 265 ] Uranium exists predominantly in two environmentally important oxidation states, U(IV) and U(VI).…”

An Alternative Approach to Cataract Surgery Using BSS Temperature of 2.7 °C

“…Surgical damage to the endothelium can have severe consequences on functional outcome and on the consequent recovery of the patient [7]. For this reason, for many years, technological research has been devoted to reducing this loss, for example by using fewer ultrasounds, thanks to femtosecond lasers [10][11][12][13]. Joussen et al [14] used a cold irrigation temperature solution during phacoemulsification.…”