Corneal endothelial cell loss after trabeculectomy and phacoemulsification in one or two steps: a prospective study

Abstract Objective The objective of this study was to analyse the results of the surgical treatment of coexisting cataract and glaucoma and its effects on corneal endothelial cell density (CECD). Methods We include two longitudinal prospective studies: one randomised that included 40 eyes with open angle glaucoma that received one- (n = 20) or two-step (n = 20) phacotrabeculectomy and another that included 20 eyes that received phacoemulsification. We assess the impact of surgery on different clinical variables and in particular in CECD using Confoscan 4™ confocal microscopy and semiautomatic counting methods. Results Phacoemulsification and phacotrabeculectomy, but not trabeculectomy, increase significantly best-corrected visual acuity and anterior chamber depth and trabeculectomy and one- or two-step phacotrabeculectomy decreased similarly the intraocular pressure. We document percentages of endothelial cell loss of 3.1%, 17.9%, 31.6% and 42.6% after trabeculectomy, phacoemulsification and one- or two-step phacotrabeculectomy, respectively. The coefficient of variation did not increase significantly after surgery but the percentage of hexagonality decreased significantly after phacoemulsification and after two-step phacotrabeculectomy. Conclusions Trabeculectomy, phacoemulsification and phacotrabeculectomy are surgical techniques that cause morphological changes and decrease the densities of the corneal endothelial cells. Trabeculectomy produces lesser endothelial cell loss than phacoemulsification, and phacoemulsification lesser cell loss than phacotrabeculectomy. Two-step phacotrabeculectomy (trabeculectomy followed 3 months later by phacoemulsification) causes more cell loss than one-step phacotrabeculectomy, and this could be due to the cumulative effects of two separate surgical traumas or to a negative conditioning lesion effect of the first surgery. For the treatment of coexisting glaucoma and cataract, one-step phacotrabeculectomy is the treatment of choice.

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Sodium Ferulate Attenuates Lidocaine-Induced Corneal Endothelial Impairment

Oxidative Medicine and Cellular Longevity ◽

10.1155/2018/4967318 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Guojian Jiang ◽

Tingjun Fan

Keyword(s):

Endothelial Cells ◽

Endothelial Cell ◽

Morphological Changes ◽

Corneal Thickness ◽

Cell Loss ◽

Corneal Endothelial Cell ◽

Corneal Endothelial Cells ◽

Endothelial Cell Loss ◽

Sodium Ferulate ◽

Human Corneal Endothelial Cells

The introduction of intracameral anaesthesia by injection of lidocaine has become popular in cataract surgery for its inherent potency, rapid onset, tissue penetration, and efficiency. However, intracameral lidocaine causes corneal thickening, opacification, and corneal endothelial cell loss. Herein, we investigated the effects of lidocaine combined with sodium ferulate, an antioxidant with antiapoptotic and anti-inflammatory properties, on lidocaine-induced damage of corneal endothelia with in vitro experiment of morphological changes and cell viability of cultured human corneal endothelial cells and in vivo investigation of corneal endothelial cell density and central corneal thickness of cat eyes. Our finding indicates that sodium ferulate from 25 to 200 mg/L significantly reduced 2 g/L lidocaine-induced toxicity to human corneal endothelial cells, and 50 mg/L sodium ferulate recovered the damaged human corneal endothelial cells to normal growth status. Furthermore, 100 mg/L sodium ferulate significantly inhibited lidocaine-induced corneal endothelial cell loss and corneal thickening in cat eyes. In conclusion, sodium ferulate protects human corneal endothelial cells from lidocaine-induced cytotoxicity and attenuates corneal endothelial cell loss and central corneal thickening of cat eyes after intracameral injection with lidocaine. It is likely that the antioxidant effect of sodium ferulate reduces the cytotoxic and inflammatory corneal reaction during intracameral anaesthesia.

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Effects of anterior chamber depth and axial length on corneal endothelial cell density after phacoemulsification

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.35.1.92 ◽

2018 ◽

Vol 35 (1) ◽

Author(s):

Muhammad Khalid ◽

Sameer Shahid Ameen ◽

Nauman Ayub ◽

Mohammad Asim Mehboob

Keyword(s):

Endothelial Cell ◽

Anterior Chamber ◽

Cell Density ◽

Axial Length ◽

Anterior Chamber Depth ◽

Cell Loss ◽

Corneal Endothelial Cell ◽

Endothelial Cell Density ◽

Endothelial Cell Loss ◽

Corneal Endothelial Cell Density

Objective: To evaluate mean decrease in Corneal Endothelial cell Density (CED) after phacoemulsification in patients with different Anterior Chamber Depths (ACDs) and Axial Lengths (ALs). Methods: This prospective stratified controlled study was conducted at PNS Shifa Hospital, Karachi. One hundred eyes of 90 patients, scheduled to undergo phacoemulsification surgery, were included. AL and ACD of each patient were calculated preoperatively using IOL Master. Cataracts were classified according toLens Opacities Classification System III (LOCS III) giving nuclear opalescence (NO) grades on slit lamp examination and only patients with grades NO2 and NO3 were included.Eyes were divided into two groups according to ACD and AL: Group-I: ACD 2.0mm – 3 mm and AL 22mm – 23.5mm; Group-II: ACD 3.1 mm -4.0 mm and AL 23.6mm – 25mm. CED measurements were done preoperatively and 2 month postoperatively using specular microscopy. The difference in CED change (Endothelial Cell Loss) between the two groups after surgery was analyzed using SPSS, v 22; IBM Corporation, Armonk, NY. Results: Differences in gender, laterality, age and preoperative CED between two groups were not significant. Difference in postoperative CED was also not significant, however difference in mean change and mean frequency change in CED between two groups was found to be statistically significant. Conclusion: ACD and AL affect the CED during phacoemulsification and Intraocular Lens(IOL) implantation and can be considered as risk factors of peroperative endothelial cell loss. How to cite this:Khalid M, Ameen SS, Ayub N, Mehboob MA. Effects of anterior chamber depth and axial length on corneal endothelial cell density after phacoemulsification. Pak J Med Sci. 2019;35(1):---------. doi: https://doi.org/10.12669/pjms.35.1.92 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Serial corneal endothelial cell loss with lathe-cut and injection-molded posterior chamber intraocular lenses

American Intra-Ocular Implant Society Journal ◽

10.1016/s0146-2776(83)80060-3 ◽

1983 ◽

Vol 9 (3) ◽

pp. 301-305 ◽

Cited By ~ 9

Author(s):

Manus C. Kraff ◽

Donald R. Sanders ◽

Howard L. Lieberman

Keyword(s):

Endothelial Cell ◽

Cell Loss ◽

Corneal Endothelial Cell ◽

Intraocular Lenses ◽

Posterior Chamber ◽

Endothelial Cell Loss ◽

Injection Molded

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Influence of anterior chamber depth, anterior chamber volume, axial length, and lens density on postoperative endothelial cell loss

Graefe s Archive for Clinical and Experimental Ophthalmology ◽

10.1007/s00417-015-2934-1 ◽

2015 ◽

Vol 253 (5) ◽

pp. 745-752 ◽

Cited By ~ 12

Author(s):

Anna Reuschel ◽

Holger Bogatsch ◽

Nicole Oertel ◽

Renate Wiedemann

Keyword(s):

Endothelial Cell ◽

Anterior Chamber ◽

Axial Length ◽

Anterior Chamber Depth ◽

Cell Loss ◽

Endothelial Cell Loss ◽

Chamber Volume ◽

Anterior Chamber Volume ◽

Lens Density

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Corneal Endothelial Cell Loss after Baerveldt Glaucoma Implant Surgery

Ophthalmology Glaucoma ◽

10.1016/j.ogla.2020.06.012 ◽

2020 ◽

Author(s):

Scott Hau ◽

Catey Bunce ◽

Keith Barton

Keyword(s):

Endothelial Cell ◽

Cell Loss ◽

Corneal Endothelial Cell ◽

Endothelial Cell Loss ◽

Implant Surgery ◽

Baerveldt Glaucoma Implant

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ASSOCIATION BETWEEN ANTERIOR CHAMBER DEPTH AND ENDOTHELIAL CELL LOSS AFTER PHACOEMULSIFICATION

10.36106/3003832 ◽

2021 ◽

pp. 30-31

Author(s):

Gargi Verma ◽

Kishor Kumar

Keyword(s):

Endothelial Cell ◽

Anterior Chamber ◽

Cell Damage ◽

Anterior Chamber Depth ◽

Cell Loss ◽

Endothelial Cell Loss ◽

Endothelial Cell Damage ◽

Percentage Decrease ◽

Central Cornea ◽

Shallow Anterior Chamber

Purpose: To assess the association between anterior chamber depth and endothelial cell loss after phacoemulsication Material and Methods: Ninety patients were recruited for this comparative type of observational study who were further divided into 3 groups according to anterior chamber depth (ACD). All patients underwent phacoemulsication procedure and intraocular implantation. Postoperatively endothelial cell loss (ECL) was calculated by measuring percentage decrease in endothelial cell density of central cornea and regression coefcient between ACD and ECLwas assessed in each group. Results: Endothelial cell loss was signicantly higher in shallow anterior chambers to other groups and the association between ACD and ECLwas signicant only in shallow anterior chamber depth group. Conclusion: Eyes with shallow anterior chamber depth are at higher risk for endothelial cell damage and shows an association between ACD and ECLwhen compared to deep anterior chamber depth.

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