Influence of Cataract Surgery on Corneal Endothelial Cell Density Estimation

Wirbelauer, C; Wollensak, Gregor; Pham, D. T.

doi:10.1097/01.ico.0000141234.48967.e3

Cited by 25 publications

(19 citation statements)

References 25 publications

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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: 57%

“…Therefore, endothelial changes and alterations of central corneal thickness (CCT) are considered important parameters of surgical trauma and are indispensable in evaluating the safety of new surgical methods. [1][2][3] Endothelial cell loss (ECL) is a complication that has been described in all types of cataract surgery and is widely investigated in the literature. The results on mean ECL vary from 0.4 to 27.7% after phacoemulsification, depending on different surgical techniques.…”

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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Section: Discussionsupporting

confidence: 57%

Section: Introductionmentioning

confidence: 99%

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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“…Several studies have been performed comparing different surgical techniques and modes of modulating the physical parameters of the phacoemulsifier, with the objective of demonstrating the benefits of reducing conventional phacoemulsification-induced corneal edema, but very few studies have compared the technique of conventional phacoemulsification with liquefaction of the lens core by Aqualase ® (2,3,7,8,11,(15)(16)(17)(18)(19) . The purpose of this study is to assess central corneal edema and visual recovery after cataract surgery performed according to two approaches: conventional phacoemulsification and liquefaction by Aqualase ® .…”

Section: Introductionmentioning

confidence: 99%

“…In order to reduce endothelial injury, the following alternatives have been developed: viscoelastic substances (12)(13)(14)(15) ; special surgical techniques such as, for example, nuclear prefracture; and new modalities of tip vibration at ultrasonic frequency, such as the White-star ® , Neosonix ® , dynamic rising time and torsional systems (1,2,5,6,(16)(17)(18)(19)(20)(21)(22)(23) . By the year 2000, an alternative technology was proposed for cataracts surgery (5,16,17) .…”

Section: Introductionmentioning

confidence: 99%

Comparison of central corneal edema and visual recovery between liquefaction and conventional phacoemulsification in soft cataracts

Nakano¹,

Hida²,

Kara‐José³

et al. 2009

Rev. bras.oftalmol.

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Purpose:The aim of the present study is to assess central corneal edema and visual recovery after cataract surgery performed according to two technologies: conventional ultrasonic and liquefaction (Aqualase ® ). Methods: This is a prospective contralateral study in wich 20 patients with comparable preoperative conditions were submitted to cataract surgery were evaluated. Preoperative assessment involved complete ophthalmological examination and the study included patients with bilateral cataracts up to grade 2, according to the Lens Opacity Classification System II. The same cristaline fracture technique was used in all cases, and surgical procedures were performed by the same experienced surgeon, using two technologies: liquefaction or conventional phacoemulsification. Postoperative central corneal edema was measured by corneal optical pachymetry (Orbscan II ® ) on the 1 st , 3 rd , 7 th and 10 th postoperative days. Results: None of the 20 patients submitted to surgery was lost during the postoperative follow-up or excluded from the analysis. On the first postoperative, the visual acuity average was 0.031 logMAR in the Aqualase ® group and 0.043 logMAR in the conventional surgery group. No statistical difference was detected in the assessment of visual acuity throughout the postoperative period. Central corneal pachymetry varied from 543.93 + 34.69 preoperatively to 545.08 ± 25.67 on the last day of follow-up in the Aqualase ® group, and from 543.13 + 30.62 to 536.08 + 34.89 in the conventional technique group, without statistical significance. Conclusion: This study suggests that both techniques are equally effective for surgery on lenses with grade I or II cataract, and that they provide similar results in terms of visual recovery and central corneal edema.

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“…If the density of endothelial cells becomes too low, the clarity of the cornea is threatened (Bourne et al 1976;Waring et al 1982). It is therefore important to evaluate the corneal endothelium prior to anterior segment surgery (Wirbelauer et al 2005). …”

Section: Introductionmentioning

confidence: 99%

Simulation of specular microscopy images of corneal endothelium, a tool for control of measurement errors

Bucht

Söderberg

Manneberg

2011

Acta Ophthalmologica

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Purpose:We aimed at developing simulation software capable of producing images of corneal endothelium close to identical to images captured by clinical specular microscopy with defined morphometrical characteristics. It was further planned to demonstrate the usefulness of the simulator by analysing measurement errors associated with a trained operator using a commercially available semi-automatic algorithm for analysis of simulated images.Methods: Software was developed that allows creation of unique images of the corneal endothelium expressing morphology close to identical with that seen in images of corneal specular microscopy. Several hundred unique images of the corneal endothelium were generated with randomization, spanning a physiological range of endothelial cell density. As an example of the usefulness of the simulator for analysis of measurement errors in corneal specular microscopy, a total of 12 of all the images generated were randomly selected such that the endothelial cell density expressed was evenly distributed over the physiological range of endothelial cell density. The images were transferred to a personal computer. The imagenet-640 software was used to analyse endothelial cell size variation, percentage of hexagonal endothelial cells, and endothelial cell density. Results:The simulator developed allows randomized generation of corneal specular microscopy images with a preset expected average and variation of cell structure. Calculated morphometric information of each cell is stored in the simulator. The image quality can secondarily be varied with a toolbox of filters to approximate a large spectrum of clinically captured images. As an example of the use of the simulator, measurement errors associated with one trained operator using the imagenet-640 software, and focusing on endothelial cell density, were examined. The functional dependence between morphometric information estimated with the imagenet-640 software algorithm and real morphometric information as provided by the simulator was analysed with regression. It was demonstrated that that the estimations of endothelial cell size variation was associated with a scaling error and that the random error was strongly dependent on the operator. Conclusion:The newly developed simulator for randomized generation of morphometrically defined corneal specular microscopy images for the first time makes it possible to estimate a spatial scaling error of an available semi-automatic algorithm and to determine the random measurement error of important morphometric estimates in a defined reference sample of images. It is anticipated that the simulator will be a valuable tool for the generation of a large set of morphometrically well-characterized corneal specular microscopy images that can be used for calibration among research centres, for minimization of random errors and for measurement of quality control. Simulated images will be useful for the development of fully automatic analysis of corneal endothelial cell morphometry.

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Influence of Cataract Surgery on Corneal Endothelial Cell Density Estimation

Cited by 25 publications

References 25 publications

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

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

Comparison of central corneal edema and visual recovery between liquefaction and conventional phacoemulsification in soft cataracts

Simulation of specular microscopy images of corneal endothelium, a tool for control of measurement errors

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