The state of corneal endothelial cells in the dynamics of surgical treatment of age-related and diabetic cataracts

2021 ◽  
pp. 47-50
Author(s):  
S.Y. Totskova ◽  
◽  
A.E. Babushkin ◽  
Е.M. Garipova ◽  
◽  
...  

Purpose. To assess the state of the corneal endothelium in patients with diabetic and immature age - related cataracts before and in the long term after phacoemulsification. Material and methods. There were 25 patients (43 eyes) under observation in total. The average age is 66.4±10.1 years. There were 12 men and 13 women among the surveyed. The average time after cataract phacoemulsification was 5.6±1.7 years. There were 2 groups of patients: group I (main) included 10 patients (16 eyes) with diabetic cataract, group 2 (control) consisted of 15 patients (27 eyes) with immature senile cataract (ISC) without diabetes. Before and after phacoemulsification the central corneal thickness (CCT), as well as polymegatism, pleomorphism, and corneal endothelial cell density (ECD) were studied using an EM-2000 endothelial microscope (Nidek, Japan). Results. In the long-term period after cataract phacoemulsification there was decreasing trend in the corneal endothelial cell density (ECD) as in patients operated on for immature senile and especially diabetic cataracts (by 1.5 times). The initial data of ECD in patients with diabetic cataract in comparison with ISC were lower although not significantly. There was also a decreasing trend in the percentage of hexaganality and the number of normal endothelial cells, as well as an increase in the coefficient of their polymegatism after phacoemulsification in patients with DM in comparison with patients without it. Conclusion. The study showed that phacoemulsification of diabetic cataracts is associated with more pronounced damage to the corneal endothelium when compared with the ISC group. During phacoemulsification with IOL implantation, especially in patients with diabetic cataracts, you should pay attention to the initially possible smaller ECD and take this circumstance into account when performing phacoemulsification. Key words: diabetic cataract, surgical treatment, phacoemulsification, endothelial microscopy, corneal endothelial cells.

2019 ◽  
Vol 12 (1) ◽  
pp. 50-55
Author(s):  
V. V. Potemkin ◽  
T. S. Varganova ◽  
E. V. Ageeva

The effect of pseudoexfoliation syndrome (PEХ) on endothelial cells has been studied long enough. Yet the effect of phacoemulsification (PHACO) on endothelium in patients with PEХ is less explored.Purpose. To assess the impact of PHACO on corneal endothelial cell density (ECD) and on the coefficient of variation (CV) in patients with PEX.Material and methods. 30 patients (30 eyes) with PEX syndrome and 34 patients (34 eyes) with no such syndrome were examined before and after phacoemulsification.Results. In patients with PEX, the ECD after PHACO was significantly lower and CV was significantly higher (р < 0.05).Conclusion. PEX has a negative impact on endothelial cells, which leads to a pronounced cells loss after PHACO.


2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Xu Chen ◽  
Yi Shao ◽  
Shi-Nan Wu ◽  
Shan-Bi Zhou

Objective. To observe the morphological changes and abnormal structure of corneal endothelial cells in children with uveitis, to analyze the related factors affecting the morphological changes of corneal endothelial cells, and to explore the clinical application of a corneal endothelial microscope in children with uveitis. Methods. The corneal endothelial cells of 70 patients with uveitis were photographed with the Topcon SP-3000 noncontact corneal endothelial microscope, and the corneal endothelial cell density (CD), average cell area (AVE), coefficient of variation of the cell area (CV), and percentage of hexagonal cells (PHC) were measured with the IMAGEnet system. Twenty-eight patients (56 eyes) with monocular uveitis were selected, with the affected eyes (28 eyes) as the experimental group and the contralateral healthy eyes (28 eyes) as the control group. The corneal endothelial cell parameters between the two groups were statistically analyzed. The parameters of corneal endothelial cells in 70 children with uveitis were compared, and the effects of the course of the disease, inflammatory cells in the anterior chamber, and posterior corneal deposition (KP) on the parameters of corneal endothelial cells were analyzed. Results. There are four abnormal forms of the corneal endothelium in children with uveitis: enlarged cell area gap, irregular cell shape, blurred intercellular space, and cell loss. KP showed irregular high reflective white spots in the corneal endothelial microscope images, surrounded by dark areas, and existed in all the eyes with dusty KP found in slit lamp examination and a small number of eyes without obvious KP. Comparing the corneal endothelial cell parameters between the experimental group and the control group, it was found that the corneal endothelial CD and PHC of the former were lower than those of the latter, and the difference was statistically significant ( P < 0.001 and P = 0.018 , respectively). The AVE and CA of the former were higher than those of the latter ( P = 0.013 and P = 0.046 , respectively). The corneal endothelial cell density of the eyes with a course of the disease of more than 1 year was lower than that of the eyes with a course of the disease less than 1 year, the coefficient of variation of the corneal endothelial cell area of the eyes with KP was higher than that of the eyes without KP, and the difference was statistically significant ( P = 0.003 and P = 0.030 , respectively). Conclusion. Corneal endothelial microscopy is one of the important methods for the detection of uveitis with high sensitivity. The change of morphological parameters of corneal endothelial cells is one of the important indexes to assist in the diagnosis of uveitis and can be further promoted in ophthalmological examination.


Cornea ◽  
2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Kanae Kayukawa ◽  
Koji Kitazawa ◽  
Koichi Wakimasu ◽  
Sanjay V. Patel ◽  
John Bush ◽  
...  

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Guojian Jiang ◽  
Tingjun Fan

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.


2018 ◽  
Vol 10 ◽  
pp. 251584141881580 ◽  
Author(s):  
Sepehr Feizi

A transparent cornea is essential for the formation of a clear image on the retina. The human cornea is arranged into well-organized layers, and each layer plays a significant role in maintaining the transparency and viability of the tissue. The endothelium has both barrier and pump functions, which are important for the maintenance of corneal clarity. Many etiologies, including Fuchs’ endothelial corneal dystrophy, surgical trauma, and congenital hereditary endothelial dystrophy, lead to endothelial cell dysfunction. The main treatment for corneal decompensation is replacement of the abnormal corneal layers with normal donor tissue. Nowadays, the trend is to perform selective endothelial keratoplasty, including Descemet stripping automated endothelial keratoplasty and Descemet’s membrane endothelial keratoplasty, to manage corneal endothelial dysfunction. This selective approach has several advantages over penetrating keratoplasty, including rapid recovery of visual acuity, less likelihood of graft rejection, and better patient satisfaction. However, the global limitation in the supply of donor corneas is becoming an increasing challenge, necessitating alternatives to reduce this demand. Consequently, in vitro expansion of human corneal endothelial cells is evolving as a sustainable choice. This method is intended to prepare corneal endothelial cells in vitro that can be transferred to the eye. Herein, we describe the etiologies and manifestations of human corneal endothelial cell dysfunction. We also summarize the available options for as well as recent developments in the management of corneal endothelial dysfunction.


2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Abd Elaziz Mohamed Elmadina ◽  
Raghda Faisal Abdelfatah ◽  
Saif Hassan Alrasheed ◽  
Mustafa Abdu ◽  
Manzoor Ahmad Qureshi

Purpose:  To compare the corneal endothelial cells morphology and central corneal thickness (CCT) before and after phacoemulsification in Sudanese population. Place and Duration of Study:  Al-Neelain eye hospital, Khartoum, Sudan, from January 2018 to May 2018. Study Design:  Observational longitudinal study. Methods:  One hundred and forty eyes of 140 patients with immature senile cataract were selected by convenient sampling. The age ranged from 40 to 85 years. The patients underwent complete ocular examination including morphology of corneal endothelial cells and CCT using computerized non-contact specular microscope. Inclusion criteria for the study was eyes with normal corneal endothelial cells and cell density more than 1000 cells/mm2. We excluded patients with ocular or systemic diseases, previous history of intraocular surgery, refractive surgery or trauma as well as contact lenses wear. The patients underwent phacoemulsification by a single surgeon. The examination parameters were repeated one month after surgery. Descriptive and comparative statistical analyses were performed using SPSS for Windows Version 21.0. Results:  There was significant reduction in mean endothelial cells density after phacoemulsification compared to baseline with p < 0.001. There was also significant post-operative reduction in mean endothelial cells number as compared to baseline (P value < 0.001). Mean endothelial cells hexagonality was reduced after surgery with P value of 0.003. No significant difference was found between mean coefficient variation of endothelial cells size before and after phacoemulsification (P = 0.55). Central corneal thickness showed significant increase post-operatively, P = 0.003. Conclusion:  Phacoemulsification causes significant damage to corneal endothelium cells, including decrease in corneal endothelial cell density, hexagonality and cell number. Key Words:  Corneal endothelium, Endothelial cell density, Central corneal thickness, Phacoemulsification.


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