scholarly journals A Comparison of Endothelial Cell Loss in Combined Cataract and MIGS (Hydrus) Procedure to Phacoemulsification Alone: 6-Month Results

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Antonio M. Fea ◽  
Giulia Consolandi ◽  
Giulia Pignata ◽  
Paola Maria Loredana Cannizzo ◽  
Carlo Lavia ◽  
...  
Keyword(s):  
Endothelial Cell ◽  
Cataract Surgery ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Cell Loss ◽  
Endothelial Cell Loss ◽  
Age Related ◽  
Before And After ◽  
Group 2 ◽  
Group 1

Purpose. To compare the corneal endothelial cell loss after phacoemulsification, alone or combined with microinvasive glaucoma surgery (MIGS), in nonglaucomatous versus primary open angle glaucoma (POAG) eyes affected by age-related cataract.Methods. 62 eyes of 62 patients were divided into group 1 (n=25, affected by age-related cataract) and group 2 (n=37, affected by age-related cataract and POAG). All patients underwent cataract surgery. Group 2 was divided into subgroups A (n=19, cataract surgery alone) and B (n=18, cataract surgery and MIGS). Prior to and 6 months after surgery the patients’ endothelium was studied. Main outcomes were CD (cell density), SD (standard deviation), CV (coefficient of variation), and 6A (hexagonality coefficient) variations after surgeries.Results. There were no significant differences among the groups concerning preoperative endothelial parameters. The differences in CD before and after surgery were significant in all groups: 9.1% in group 1, 17.24% in group 2A, and 11.71% in group 2B. All endothelial parameters did not significantly change after surgery.Conclusions. Phacoemulsification determined a loss of endothelial cells in all groups. After surgery the change in endothelial parameters after MIGS was comparable to the ones of patients who underwent cataract surgery alone.

scholarly journals Endothelial Cell Loss Rate Following Penetrating Keratoplasty: Optical versus Therapeutic Grafts

2021 ◽  
Author(s):  
Abdelrhman Shams ◽  
Ayman Gaafar ◽  
Rania Elkitkat ◽  
Mohamed Yousif
Keyword(s):  
Endothelial Cell ◽  
Graft Rejection ◽  
Penetrating Keratoplasty ◽  
Cell Loss ◽  
P Value ◽  
Specular Microscopy ◽  
Endothelial Cell Loss ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Abstract Purpose: To compare the rate of endothelial cell loss (ECL) following penetrating keratoplasty (PKP) for optical and therapeutic indications and to state whether therapeutic PKP is inferior to optical PKP or not.Methods: This is a Prospective, observational, comparative study that included patients who sought medical advice at the Cornea Outpatient Clinic of Ain Shams University Hospitals. The study enrolled two groups; group 1 included 30 corneas of 30 patients who performed optical PKP for various purposes, while group 2 comprised 30 corneas of 30 patients who were planned for performing therapeutic PKP for unhealed, resistant corneal infections. Specular microscopy was done to all the patients at the 3-, 6- and 12-months visits using Nidek CEM-530 (NIDEK Co., Ltd. Japan) specular microscope. Results: There were no statistically significant differences between both groups as regards to the timing of the graft clarity following surgery or the rate of ECL at the 3- and 6- months intervals, yet the rate of ECL was significantly higher in group 2 compared to group 1 at the 12 months interval (P-value <0.05), though the statistical difference was narrow from a clinical point of view. There was also no statistically significant difference between both groups regarding the rate of graft rejection.Conclusion: Therapeutic PKP can be considered non-inferior to optical PKP regarding the graft viability, the rate of ECL, and the rate of graft rejection along a follow up interval of one year.

scholarly journals Endothelial cell loss rate after penetrating keratoplasty: Optical versus therapeutic grafts

2021 ◽  
Vol 10 (2) ◽  
pp. 74-79
Author(s):  
Abdelrhman Shams ◽  
Ayman Abdelmoneim Gaafar ◽  
Rania Serag Elkitkat ◽  
Mohamed Omar Yousif
Keyword(s):  
Endothelial Cell ◽  
Graft Rejection ◽  
Penetrating Keratoplasty ◽  
Cell Loss ◽  
Specular Microscopy ◽  
Endothelial Cell Loss ◽  
Group 2 ◽  
Cell Loss Rate ◽  
Group 1

Background: This study aimed to compare the rate of endothelial cell loss (ECL) after penetrating keratoplasty (PKP) for optical versus therapeutic grafts at 3-, 6-, and 12-month postoperatively. Furthermore, the study aimed to investigate postoperative graft viability and the rate of graft rejection during the first year of follow-up for both indications. Methods: This was a prospective, observational, comparative study that included patients who sought medical advice at the cornea outpatient clinic of Ain Shams University Hospitals, Cairo, Egypt. The study recruited 60 patients: group 1 included 30 transplanted corneas of 30 patients who underwent optical PKP for various indications, while group 2 included 30 transplanted corneas of 30 patients who underwent therapeutic PKP for unhealed, resistant infectious keratitis. Specular microscopy was performed for all patients at the 3-, 6-, and 12-month follow-up visits using Nidek CEM-530 specular microscopy. Postoperative clinical examinations were performed at the same follow-up visits to detect graft rejection. Results: There were no statistically significant differences between the groups concerning the postoperative timing of graft clarity or the rate of ECL at 3- and 6-months postoperatively; however, the rate of ECL was significantly greater in group 2 than in group 1 at 12-months postoperatively (P = 0.03), although the difference was small from a clinical point of view. Moreover, there was no statistically significant difference between the groups in terms of the graft rejection rate. Conclusions: Therapeutic PKP results were comparable to optical PKP with respect to graft viability, the rate of ECL, and the rate of graft rejection 1 year after grafting. How to cite this article: Shams A, Abdelmoneim Gaafar A, Elkitkat RS, Omar Yousif M. Endothelial cell loss rate after penetrating keratoplasty: Optical versus therapeutic grafts. Med Hypothesis Discov Innov Ophthalmol. 2021 Summer; 10(2): 74-79. https://doi.org/10.51329/mehdiophthal1424

scholarly journals Evaluation of the Effect of the First Generation iStent on Corneal Endothelial Cell Loss—A Match Case-Control Study

2021 ◽  
Vol 10 (19) ◽  
pp. 4410
Author(s):  
Joanna Konopińska ◽  
Emil Saeed ◽  
Łukasz Lisowski ◽  
Kinga Gołaszewska ◽  
Paweł Kraśnicki ◽  
...  
Keyword(s):  
Endothelial Cell ◽  
Open Angle Glaucoma ◽  
Glaucoma Surgery ◽  
Cell Loss ◽  
Corneal Endothelial Cell ◽  
Control Group ◽  
Open Angle ◽  
Long Term Effects ◽  
Endothelial Cell Loss ◽  
Significant Difference

Glaucoma is the leading cause of irreversible blindness worldwide. The only proven factor in slowing the progression of glaucomatous neuropathy is lower intraocular pressure (IOP), which can be achieved with pharmacology, laser therapy, or surgery. However, these treatments are associated with various adverse effects, including corneal endothelial cell loss (CECL). In recent years, several novel surgeries for reducing the IOP, collectively referred to as minimally invasive glaucoma surgery (MIGS), have been developed, one of which is the iStent. However, the long-term effects of such surgeries remain unknown. We compared a group of patients with open-angle glaucoma and cataract who underwent phacoemulsification alone with a group of patients with similar demographic and clinical characteristics who underwent simultaneous phacoemulsification and iStent implantation. Overall, 26 eyes of 22 subjects who underwent a combined phacoemulsification-iStent procedure and 26 eyes of 24 subjects who underwent cataract surgery were included. Before surgery, endothelial cells accounted to 2228.65 ± 474.99 in iStent group and 2253.96 ± 404.76 in the control group (p = 0.836). After surgery, their number declined to 1389.77 ± 433.26 and 1475.31 ± 556.45, respectively (p = 0.509). There was no statistically significant difference in CECL between the two groups 18–24 months after surgery, despite increased manipulation in the anterior chamber and the presence of an implant in the trabecular meshwork in those with an iStent implant. Thus, iStent bypass implantation is a safe treatment in terms of CECL for mild-to-moderate open-angle glaucoma.

Comparison of endothelial cell changes by specular microscopy between Ringer’s and Ringer’s lactate during phacoemulsification

2020 ◽  
Vol 1 (4) ◽  
pp. 218-223
Author(s):  
Eman Desoky ◽  
◽  
Hany Ahmed Helaly ◽  
Keyword(s):  
Endothelial Cell ◽  
Corneal Thickness ◽  
Cell Loss ◽  
Specular Microscopy ◽  
Ringer’S Solution ◽  
Age Related ◽  
Ringer’S Lactate ◽  
The Difference ◽  
Group 2 ◽  
Group 1

AIM: To compare the difference between using Ringer’s and Ringer’s lactate (RL) solutions as irrigating solutions during phacoemulsification and investigate their effect on corneal endothelium. METHODS: This was a prospective interventional double blinded clinical study that included 100 eyes of 100 patients aged between 50 to 65y suffering from a visually significant age-related cataract and scheduled for routine uncomplicated phacoemulsification. The included eyes were randomly divided into two equal groups (each group included 50 eyes). Group 1 received Ringer’s solution and group 2 received Ringer’s lactate as an irrigating solution. RESULTS: The first group with Ringer’s solution had a mean age of 57.5±8y and the second group with RL solution had a mean age of 58.6±9y. After 3mo, endothelial cell density decreased in group 1 by a mean of 8.5%, and in group 2 by a mean of 3.6% (P=0.013). Additionally, central corneal thickness increased in group 1 by a mean of 6.9% and in group 2 by a mean of 1.5% (P=0.006). By correlating the percentage of change in pachymetry and specular microscopic parameters with volume of irrigation solution used, there was no significant correlation. CONCLUSION: The use of Ringer’s lactate as an irrigating solution is associated with less endothelial cell loss postoperatively in comparison to Ringer’s solution and associated with decreased postoperative edema.

Long-term endothelial cell loss and breakdown of the blood-aqueous barrier in cataract surgery

1991 ◽  
Vol 17 (5) ◽  
pp. 622-627 ◽  
Author(s):  
V. M.G. Ambrose ◽  
R. F. Walters ◽  
M. Batterbury ◽  
D. J. Spalton ◽  
J. I. McGill
Keyword(s):  
Endothelial Cell ◽  
Cataract Surgery ◽  
Cell Loss ◽  
Endothelial Cell Loss ◽  
Blood Aqueous Barrier

scholarly journals Outcomes of coaxial microincision cataract surgery versus conventional phacoemulsification surgery

2019 ◽  
Vol 16 (3) ◽  
pp. 168-178
Author(s):  
Anu Malik ◽  
Smruti Ranjan Dethi ◽  
Yogesh Kumar Gupta ◽  
Alka Gupta
Keyword(s):  
Cataract Surgery ◽  
Randomized Study ◽  
Corrected Visual Acuity ◽  
Age Related ◽  
Significant Difference ◽  
Induced Astigmatism ◽  
The Mean ◽  
Group 2 ◽  
Surgically Induced ◽  
Group 1

Aim: To compare surgical parameters and visual outcomes of coaxial microincision cataract surgery (MICS) with standard phacoemulsification. Methods: A prospective randomized study was conducted on 60 eyes of 60 patients with age-related uncomplicated cataract who underwent: standard phacoemulsification surgery (30 eyes) i.e., Group 1, or coaxial MICS (30 eyes) i.e., Group 2. Intraoperative parameters were mean effective phacoemulsification power (EPP), effective phacoemulsification time (EPT), and total volume of balanced salt solution (BSS) used. Best-corrected visual acuity (BCVA) and surgically induced astigmatism (SIA) were evaluated pre- and postoperatively. Results: Mean BCVA at 6 weeks was 0.04 ± 0.07 in Group 1 and 0.05 ± 0.08 in Group 2. No significant difference was observed in SIA between the two groups. Mean EPT was 29.80 ± 3.67 seconds in Group 1 and 31.93 ± 4.08 seconds in Group 2. The mean total EPP in Group 1 was 35.77 ± 5.17%, whereas it was 33.70 ± 3.05% in Group 2. There was a significant statistical difference between mean EPP and EPT in the two groups. Mean total BSS volume used in Group 1 was 128.83 ± 19.81 ml, whereas it was 139.33 ± 13.57 ml in Group 2. Conclusion: Although EPT and BSS volume used were significantly higher in coaxial MICS, the postoperative results of the two techniques were comparable.

scholarly journals Controversies in the Use of MIGS

2020 ◽  
pp. 133-145
Author(s):  
Georges M. Durr ◽  
Paola Marolo ◽  
Antonio Fea ◽  
Iqbal Ike K. Ahmed
Keyword(s):  
Clinical Practice ◽  
Endothelial Cell ◽  
Cataract Surgery ◽  
New Technologies ◽  
Unmet Need ◽  
Glaucoma Surgery ◽  
Cell Loss ◽  
Sufficient Evidence ◽  
Controversial Issues ◽  
Trabecular Bypass

Abstract Minimally invasive glaucoma surgery (MIGS) has fulfilled an unmet need in the management of glaucoma. This chapter highlights some controversial issues regarding the use of MIGS in clinical practice, including (1) whether there is sufficient evidence to advocate combining MIGS with cataract surgery over cataract surgery alone, (2) the merits and drawbacks of different approaches to trabecular bypass and canal-based MIGS procedures, (3) the effect of MIGS on endothelial cell loss, (4) suprachoroidal MIGS devices and whether there is still a role for these procedures, and (5) a comparison between subconjunctival MIGS and trabeculectomy. Several questions are still left unanswered and hopefully, further research and more clinical experience with these new technologies will help improve surgical outcomes for patients.

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