Quantitative Corneal Endothelial Evaluation in Intraocular Lens Implantation and Cataract Surgery

Hirst, Lawrence W.; Snip, Robert C.; Stark, Walter J.; Maumenee, A. Edward

doi:10.1016/0002-9394(77)90495-0

Cited by 76 publications

(17 citation statements)

References 5 publications

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“…This is probably not the case, as we performed specular microscopy in 41 of our first 100 cases and found a mean corneal endothelial-cell loss of about 15% [6], which is low in comparison with other studies in volving IOLs and was not higher than our rate of endothelial-cell loss from routine cat aract surgery without lens implantation.…”

Section: Discussionmentioning

confidence: 48%

Update of the Intraocular Lens

Stark¹,

Maumenee²

1983

Ophthalmologica

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A series of 795 primary intraocular lens (IOL) implantations performed at the Wilmer Institute during the past 6 years by two surgeons were reviewed. Progressive corneal endothelial-cell loss and an increased rate of late-onset corneal edema were detected in the group with the Morcher (European) four-loop iris-clip Binkhorst IOLs. Clinically significant cystoid macular edema was more frequent in eyes with the American four-loop Binkhorst lens, presumably due to chronic iritis caused by contaminants on the IOLs. Our short-term results with the American Shearing-type IOLs implanted at the time of extracapsular cataract extraction are encouraging, with 98% of the cases achieving 20/40 vision or better, excluding those with known macular degeneration or amblyopia. A continued cautious approach to IOL implantation is recommended.

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Section: Discussionmentioning

confidence: 48%

Update of the Intraocular Lens

Stark¹,

Maumenee²

1983

Ophthalmologica

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“…A three step clear corneal tunnel self-sealing incision was made with a 2.75 mm disposable metal blade on the steepest axis and a side port incision. After inject dispersive and cohesive ophthalmic viscosurgical devices (Celoftal and Provisc, Alcon Laboratories, Fort Worth, Texas, USA) into the anterior chamber using the soft shell technique (20) , uttrata forceps was used to grasp the capsule and perform the capsulorhexis (2) . Karate pre chop technique with Akahoshi's pre chopper to make the initial fracture and endocapsular phacoemulsification was performed in all eyes by using Infiniti ® Vision System Phacoemulsification machine (Alcon Laboratories, Fort Worth, Texas, USA) using both technologies, Aqualase ® and conventional ultrasonic unit.…”

Section: Methodsmentioning

confidence: 99%

“…S ince the 1970's, the importance of preserving the corneal endothelium has been established as a factor in the recovery from post-operatory edema (1)(2)(3) . Durovic et al has suggested that corneal edema is one of the main causes of low visual acuity in the immediate postoperative period after intraocular surger (4) .…”

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%

“…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%

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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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