The effect of anterior chamber depth on endothelial cell count and postoperative corneal edema in phacoemulsification surgery

Yıl 2011, Cilt: 38 Sayı: 2, 179 - 183, 01.06.2011

Ekrem Kadıoğlu Şaban Gönül

https://doi.org/10.5798/diclemedj.0921.2011.02.0011

Öz

Objectives: To investigate the effect of anterior chamber depth on corneal endothelial cell loss and development of postoperative corneal edema in patients undergoing pha­coemulsification surgery. Materials and methods: The effect of preoperative an­terior chamber depth was evaluated by ultrasound bi­ometry of 35 eyes with senile cataract and treated with phacoemulsification on intraoperative endothelial cell loss and at postoperative central corneal thicknesses by specular microscopy. Results: The mean age was 64.8 ± 10.7 years (range 42-84). Preoperative anterior chamber depth, cell density and central corneal thickness were 3.37 ± 0.51 mm (1.61-4.33 mm), 2345 ± 341 cell/mm² (1600-2915 cell/mm²) and 536 ± 32 μ (457-588 μ) respectively. Postoperative endothelial cell densities were detected 1876 ± 443 cell/mm², 1882 ± 457 cell/mm² and 1920 ± 456 cell/mm² at first week, first month and at third month respectively. Compared to preoperative values, decreases of endothe­lial cell densities at postoperative first week, first month and third month were found to be significant (p

Anahtar Kelimeler

Phacoemulsification, anterior chamber depth, corneal endothelial cell loss, corneal edema.

Fakoemülsifikasyon cerrahisinde ön kamara derinliğinin endotel hücre sayısı ve postoperatif korneal ödem üzerine etkisi

Öz

Amaç: Fakoemülsifikasyon cerrahisi yapılan olgularda, ön kamara derinliğinin korneal endotel hücre kaybına ve postoperatif korneal ödem gelişimine etkisinin incelenme­si. Gereç ve yöntem: Senil katarakt tanısı alıp fakoemülsifi­kasyon cerrahisi uygulanmış 35 vakanın ultrasonik biyo­metri ile ölçülen preoperatif ön kamara derinliğinin endo­tel hücre kaybı ve postoperatif santral kornea kalınlığına etkisi, speküler mikroskopi verileri kullanılarak incelendi. Bulgular: Olguların yaş ortalaması 64.8 ± 10.7 yıl (42 - 84 yaş) idi. Preoperatif ön kamara derinliği 3.37 ± 0.51 mm (1.61-4.33 mm), hücre yoğunluğu 2345 ± 341 hücre/mm² (1600-2915 hücre/mm²) santral kornea kalınlığı (SKK) 535.9 ± 32.3 μ (457-588 μ) idi. Postoperatif endotel hüc­re yoğunluğu 1. haftada 1876 ± 443 hücre/mm², 1. ayda 1882 ± 457 hücre/mm², 3. ayda 1920 ± 456 hücre/mm² olarak saptandı. Preoperatif değer ile kıyaslandığında; 1. hafta, 1. ay ve 3. aydaki hücre yoğunluğu azalmalarının anlamlı olduğu bulundu (p

Anahtar Kelimeler

Fakoemülsifikasyon, ön kamara de­rinliği, korneal endotel hücre kaybı, korneal ödem.

Kaynakça

• Ventura AC, Walti R, Böhnke M. Corneal thicness and en- dothelial density before and after cataract surgery. Br J Ophthalmol 2001;85(1):18-20.
• Hayashi K, Hayashi H, Nakao F, Hayashi F. Risk factors for corneal endothelial injury during phacoemulsification. J Cataract Refract Surg 1996;22(8):1079-84.
• Cameron MD, Poyer JF, Aust SD. Identification of free radi- cals produced during phacoemulsification. J Cataract Re- fract Surg 2001;27(3):463-70.
• Kim K, Cristol SM. Viscoelastic protection from endothe- lial damage by air bubbles. J. Cataract Refract Surg 2002;28(6):1047-53.
• Committee on Ophthalmic Procedures Assessment. Corneal endothelial photography. Ophthalmology 1991;98(9):1464-8.
• Tuft SJ, Coster DJ. The corneal endothelium. Eye 1990;4(3):389-424.
• Oral D, Karel F. Fakoemülsifikasyonun kornea endoteli üz- erine etkisi. MN Oftalmoloji 2002;9(3):219-23.
• Ernest P, Rhem M, McDermott M, Lavery K, Sensoli A. Pha- coemulsification conditions resulting in thermal wound in- jury. J. Cataract Refract Surg 2001;27(11):1829-39.
• Mencucci R, Ponchietti C, Virgili G. Corneal endothelial dam- age after cataract surgery: microincision versus standard technique. J Cataract Refract Surg 2006;32(8):1351-4.
• O’Brien PD, Fitzpatrick P, Kilmartin DJ, Beatty S. Risk factors for endothelial cell loss after phacoemulsifica- tion surgery by a junior resident. J Cataract Refract Surg 2004;30(4):839-43.
• Pereira ACA, Porfirio F, Freitas LL, Belfort R Jr. Ultrasound energy and endothelial cell loss with stop-and-chop and nu- clear preslice phacoemulsification. J Cataract Refract Surg 2006;32(10):1661-6.
• Storr-Paulsen A, Norregaard JC, Ahmed S. Endothelial cell damage after cataract surgery: divide-and-conquer versus phaco-chop technique. J Cataract Refract Surg 2008;34(6):996-1000.
• Yang Kyeung Cho, Hwa Seok Chang, Man Soo Kim. Risk Factors for Endothelial Cell Loss after Phacoemulsification: Comparison in Different Anterior Chamber Depth Groups. Korean J Ophthalmol 2010;24(1):10-5.
• Fishkind W, Bakewell B, Donnenfeld E, Rose A, Watkins A, Olson R. Comparative clinical trial of ultrasound pha- coemulsification with and without the WhiteStar system. J Cataract Refract Surg 2006;32(1):45-9.
• Walkow T, Anders N, Klebe S. Endothelial cell loss after phacoemulsification: relation to preoperative and intraoper- ative parameters. J Cataract Refract Surg 2000;26(5):727- 32.
• Lundberg B, Jonsson M, Behndig A. Postoperative corneal swelling correlates strongly to corneal endothelial cell loss after phacoemulsification cataract surgery. Am J Ophthal- mol 2005;139(6):1035-41.
• Suzuki H, Oki K, Takahashi K, Shiwa T, Takahashi H. Functional evaluation of corneal endothelium by com- bined measure-ment of corneal volume alteration and cell density after phacoemulsification. J Cataract Refract Surg 2007;33(12):2077-82.