scholarly journals Corneal status following modified Blumenthal technique of manual small incision cataract surgery (MSICS) compared to phacoemulsification in treatment of grade III or more nuclear sclerosis-cohort study

2015 ◽  
Vol 7 (1) ◽  
pp. 47-51 ◽  
Author(s):  
K Jain ◽  
K PS Malik ◽  
S Gupta
Keyword(s):  
Endothelial Cell ◽  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Cell Loss ◽  
Specular Microscopy ◽  
Endothelial Cell Loss ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Grade Iii

Objective: To evaluate the endothelial cell loss and central corneal thickness in modified Blumenthal technique of MSICS and Phacoemulsification. Method: A prospective study in which 50 cases of nuclear sclerosis grade III (LOCS III) or more were randomized in two groups of 25 each. Group A underwent modified Blumenthal MSICS. Lens expression was facilitated by viscoelastic injection through ACM and scleral pressure by iris repositor. Group B underwent 2.8 mm phacoemulsi¿cation. Specular microscopy and pachymetry were done at 1st POD, 1st, 3rd and 6th week.Results: No significant difference in endothelial cell loss and central corneal thickness between group A and group B (p > 0.05) was found.Conclusion: This technique of MSICS is not inferior, an innovative, safe and highly effective in hard cataracts.

scholarly journals A comparative study of divide and conquer, stop and chop and phaco chop techniques of nucleotomy in phacoemulsification

2021 ◽  
Vol 7 (3) ◽  
pp. 471-476
Author(s):  
Monika Dahiya ◽  
Gursimran Kaur ◽  
A K Khurana ◽  
Urmil Chawla
Keyword(s):  
Endothelial Cell ◽  
Cataract Surgery ◽  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Cell Loss ◽  
Divide And Conquer ◽  
Age Group ◽  
Endothelial Cell Loss ◽  
Endothelial Cell Count ◽  
Group A

Phacoemulsification is a variant of extracapsular cataract extraction surgery which is the gold standard treatment modality for cataract surgery nowadays. The common nucleotomy techniques of phacoemulsification are divide and conquer, stop and chop and phaco chop.Aim of this studyto compare different techniques of nucleotomy during phacoemulsification with respect to corneal endothelial cell loss, central corneal thickness (CCT) and comment on their merits and demerits. 60 patients undergoing cataract surgery by phacoemulsification were randomly divided into three groups of 20 each (Group A, B and C) who underwent nucleotomy by divide and conquer, stop and chop and phaco chop technique respectively. The preoperative endothelial cell density and central corneal thickness were recorded using Topcon SP3000P non-contrast specular microscope. All patients were followed up at 1, 4 and 12week after surgery and evaluated for vision, slit lamp examination, endothelial cell count and central corneal thickness.The age group of patients studied was 50-80 years, where maximum number of patients were in 51-60 years age group. Out of 60 patients, most common morphological type of cataract was nuclear (40%) cataract followed by cortico-nuclear (36.67%) cataract. After 1 week of surgery, drop in endothelial cell density was 7.06% in Group A, 6.49% in Group B and 6.84% in Group C patients. A further slight decrease in endothelial cell count was recorded during 4week and on final follow up visit at 12 weeks after cataract surgery, there was an endothelial cell loss of 9.51%, 10.9% and 11% in Group A, B and C respectively. The central corneal thickness at 1postoperative week increased by 2.75%, 2.35% and 2.20% in group A, B and C respectively. Further evaluation of CCT at 4and 12 week after surgery showed the values to be almost same as preoperative values. The rate of complications, which mainly included postoperative keratitis, mild anterior uveitis and cystoid macular edema, were found to be almost the same in all the three study groups.All the three nucleotomy techniques of phacoemulsification i.e divide and conquer, stop and chop and phaco chop are equally efficacious in terms of CCT changes, endothelial cell loss and complications rate in the hands of an experienced surgeon.

scholarly journals Comparison of Long-Term Outcomes of the Lamellar and Penetrating Keratoplasty Approaches in Patients with Keratoconus

2021 ◽  
Vol 10 (11) ◽  
pp. 2421
Author(s):  
Dominika Janiszewska-Bil ◽  
Barbara Czarnota-Nowakowska ◽  
Katarzyna Krysik ◽  
Anita Lyssek-Boroń ◽  
Dariusz Dobrowolski ◽  
...  
Keyword(s):  
Endothelial Cell ◽  
Adverse Events ◽  
Penetrating Keratoplasty ◽  
Corneal Thickness ◽  
Cell Loss ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Endothelial Cell Loss ◽  
Anterior Lamellar Keratoplasty ◽  
Significant Difference

We compared the visual and refractive outcomes, intraocular pressure (IOP), endothelial cell loss (ECL), and adverse events in keratoconus patients after deep anterior lamellar keratoplasty (DALK) and penetrating keratoplasty (PK) with the best corrected visual acuity (BCVA) below 0.3 (logMAR 0.52). This is a prospective, comparative cohort study of 90 eyes (90 patients) with a clinical diagnosis of keratoconus. Patients underwent a complete eye examination before the surgical approach, 6 and 12 months postoperatively that consisted of BCVA, refractive astigmatism (AS), central corneal thickness (CCT), IOP, and ECL. Secondary outcomes were adverse events related to the surgical procedure. With lower ECL and less adverse events, DALK was revealed to be beneficial over PK with similar visual outcomes. Results: There was no significant difference between the BCVA in the DALK and PK groups (at 6 months: 0.49 ± 0.17 vs. 0.48 ± 0.17; p = 0.48; at 12 months: 0.54 ± 0.17 vs. 0.52 ± 0.14; p = 0.41). The mean value of AS was significantly lower after the PK procedure when compared to DALK, after both 6 and 12 months of follow up (p < 0.001). The CCT in the DALK group was significantly lower when compared to the PK group (at 6 months: 452.1 ± 89.1 µm vs. 528.9 ± 69.9 µm, p < 0.0001; at 12 months: 451.6 ± 83.5 µm vs. 525.5 ± 37.1 µm). The endothelial cell loss at 12 months after surgery was significantly lower after DALK when compared to PK (p < 0.0001). DALK transplantation should be considered as an alternative procedure in the surgical treatment of keratoconus.

scholarly journals Comparisons of Visual and Surgical Outcomes after Reuse or Replacement of Dislocated in-the-Bag Intraocular Lens

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Takayuki Baba ◽  
Tomohiro Nizawa ◽  
Toshiyuki Oshitari ◽  
Shuichi Yamamoto
Keyword(s):  
Visual Acuity ◽  
Endothelial Cell ◽  
Intraocular Lens ◽  
Refractive Error ◽  
Surgical Outcomes ◽  
Case Series ◽  
Cell Loss ◽  
Significant Difference ◽  
Group A ◽  
Group B

Purpose. To compare the visual and surgical outcomes after a reuse or a replacement of a dislocated in-the-bag intraocular lens (IOL). Methods. This was a retrospective, nonrandomized case series at a single ophthalmological institution. Cases with an in-the-bag dislocation of an IOL were treated by pars plana vitrectomy and the reuse or the replacement of the IOL. The lens was held by intrascleral fixation of the haptics of the IOL under both conditions. The same dislocated IOL was reused in 6 eyes (group A) or it was replaced with another IOL in the other 9 eyes (group B). The pre- and postoperative parameters analyzed included the visual acuity, refractive error, corneal endothelial cell density, and intraocular pressure (IOP). Results. There was no significant difference between the two groups in the postoperative visual acuity (P=0.388), refractive error (P=0.955), IOP (P=0.529), and endothelial cell loss (P=0.940). A breakage or a tilting of the IOL was observed and required replacement in three eyes in the reuse group (P=0.044). Conclusions. Half of the cases with reused in-the-bag dislocated IOL had a breakage or a tilting of the IOL. The replacement of the in-the-bag dislocated IOL is better than the reuse of the IOL with intrascleral haptics fixation.

scholarly journals Corneal Thickness and Endothelial Morphology in Normal Thai Eyes

2020 ◽  
Author(s):  
Napaporn Tananuvat ◽  
Natawan Khumchoo
Keyword(s):  
Endothelial Cell ◽  
Cell Density ◽  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Age Groups ◽  
Inverse Correlation ◽  
Cell Loss ◽  
Endothelial Cell Density ◽  
Specular Microscopy ◽  
The Mean

Abstract Background: This study aimed to determine the influence of age on central corneal thickness and corneal endothelial morphology as well as to identify the relationship between them in normal Thai eyes.Methods: Non-contact specular microscopy was performed in volunteers stratified into seven age groups ranging from 11-88 years. The corneal endothelial parameters studied included central corneal thickness (CCT), endothelial cell density (ECD), coefficient of variation in cell size (CV), cell area (CA) and percentage of regular hexagonal cells.Results: In a total of 501 subjects (1002 eyes), the mean age was 43.12 ± 18.80 years and 347(69.3%) were females. The mean CCT, ECD, CV, CA, and hexagonality was 533.80 ± 33.00 μm, 2,732±258 cell/mm2, 37.61 ± 6.76%, 369.04 ± 37.90 mm, and 49.03% ± 7.53%, respectively. There was a statistically significant inverse correlation between age and CCT (r = -0.212, P <0.001), ECD (r = -0.484, P <0.001), and hexagonality (r = -0.193, P <0.001). The estimate rate of endothelial cell loss was 0.2% per year, whereas CV and CA had statistically significant correlation with age (r = 0.200, P <0.001 and r = 0.475, P <0.001). CCT correlated directly with ECD (r = 0.177, P <0.001).Conclusion: Normative data for corneal endothelial morphology in healthy Thai eyes showed that ECD, CCT, and hexagonality were significantly decreased, while CV and CA were increased with aging. The central corneal thickness was correlated with the endothelial cell density.

scholarly journals The Effect of Body Posture Changes and Central Corneal Thickness on Intraocular Pressure among Healthy Malays

2021 ◽  
Vol 18 (6) ◽  
Author(s):  
Nadiah RASHIDI ◽  
Md Muziman Syah MD MUSTAFA ◽  
Norsham AHMAD ◽  
Megat Ahmad Fadhil MEGAT BASRI ◽  
Nor Ariza MOHAMMAD ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Prone Position ◽  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Body Posture ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
The Relationship ◽  
Corneal Apex

Purpose: To study the relationship between intraocular pressure (IOP), posture, and central corneal thickness (CCT) among healthy Malays. Method: Thirty-four young adults had their IOPs measured using a handheld tonometer (Accutome, Pennsylvania, USA) after maintaining 5 min at four different postures; sitting upright, supine, supine & 45° inclination, and prone positions. The sequences of the postures were made random. CCT was measured using Oculus Pentacam (Oculus, Wetzlar, Germany), and the value at the corneal apex was taken. Participants were grouped into Group A with CCT of < 550 μm, and Group B of > 550 μm. Results: The highest IOP was recorded at the prone position 23.77±2.71 mmHg (p < 0.001), and the lowest was at sitting upright 15.43±2.67 mmHg (p < 0.001). IOP at the supine position was 17.31±3.07 mmHg, and at the supine & 45° inclination position was 16.00±2.80 mmHg. IOPs were significantly different between sitting upright and supine (p = 0.03), between sitting upright and prone (p < 0.001), between supine and prone (p < 0.001), and between supine & inclined 45° and prone (p < 0.001). There was no significant difference in IOPs between Group A and Group B at different postures (p > 0.05). Conclusions: Change in body posture significantly affects IOP, with the lowest IOP during the sitting upright position, and the highest at the prone position. IOP change upon posture shifts was not affected by CCT.

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 A Rabbit Model Study to Determine the Efficacy of a Prototype Corneal Endothelium Protector during Cataract Surgery

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Annabel C. Y. Chew ◽  
Anita Chan ◽  
Monisha E. Nongpiur ◽  
Gary Peh ◽  
Veluchamy A. Barathi ◽  
...  
Keyword(s):  
Corneal Endothelium ◽  
Corneal Thickness ◽  
Anterior Segment ◽  
Rabbit Model ◽  
Cell Loss ◽  
Specular Microscopy ◽  
Endothelial Cell Loss ◽  
Surgical Time ◽  
Model Study ◽  
Significant Difference

Purpose. We evaluated the efficacy and safety of a mechanical device, the P-chute, in corneal endothelium preservation during phacoemulsification in a rabbit model. Methods. Twenty-four rabbits were randomly assigned into 2 groups. One eye of each rabbit underwent phacoemulsification that simulated the removal of a dense nucleus, with or without the P-chute. Serial slit-lamp examinations, anterior segment optical coherence tomography (ASOCT) scans, and specular microscopy were performed. Three rabbits from each group were sacrificed on postoperative days (PODs) 1, 5, 7, and 14. Histological analysis of the corneas was performed. Results. There was a trend towards lesser endothelial cell loss for the P-chute group at POD1 (4.9% versus 12.5%, p=0.53), POD5 (10.4% versus 12.2%, p=0.77), and POD7 (10.5% versus 17.2%, p=0.52). There was no significant difference in the corneal thickness (p=>0.05) between the 2 groups. The insertion of the device was challenging. The use of the P-chute only added an extra 15% to the surgical time. Conclusions. There was a trend towards better endothelium preservation with the P-chute even though the results were not statistically significant. We believe that the device could be useful in certain surgical situations. Further work is needed to improve the device insertion.

scholarly journals Non-contact specular microscopy in aphakic and pseudophakic dogs

2014 ◽  
Vol 44 (4) ◽  
pp. 682-687 ◽  
Author(s):  
Claudia Emi Nagatsuyu ◽  
Priscila Barreto de Abreu ◽  
Karina Kamachi Kobashigawa ◽  
Luciano Fernandes da Conceição ◽  
Adriana Morales ◽  
...  
Keyword(s):  
Endothelial Cell ◽  
Cell Density ◽  
Cell Loss ◽  
Endothelial Cell Density ◽  
Intraocular Lenses ◽  
Specular Microscopy ◽  
Cell Area ◽  
Endothelial Cell Loss ◽  
Significant Difference ◽  
Posterior Capsular Opacity

Cataract is one of the most common ocular diseases in dogs, and phacoemulsification is considered its treatment of choice. Posterior capsular opacity (PCO) is a frequent complication and may occur weeks or months after the surgery. It is known that intraocular lenses (IOL) used for the correction of post-operative hypermetropia are an adjunctive aid in the prevention of PCOs, mainly the foldable acrylics designs with square and truncated edges. However, IOL placement may result in endothelial cell loss. This study evaluated the morphology and cellularity of the endothelium by non-contact specular microscopy in aphakic and pseudophakic dogs. Endothelial cell density, endothelial cell area, coefficient of variation and hexagonal cells percent were analyzed for each group and between groups. During all evaluation periods, endothelial cell density did not alter in any group. From days 7 to 30, endothelial cell density was higher in pseudophakic dogs. However, values returned to normal and, by the end of the study, no significant difference was observed. Cell area and variation coefficient did not differ in each group or between groups. Hexagonal cells percent significantly reduced after phacoemulsification in both groups. With time, this condition returned to initial values. When both groups were compared, hexagonal cells percent were decreased in the pseudophakic group, immediately after the surgeries.

scholarly journals Accelerated Corneal Endothelial Cell Loss after Phacoemulsification in Patients with Mildly Low Endothelial Cell Density

2021 ◽  
Vol 10 (11) ◽  
pp. 2270
Author(s):  
Hung-Chi Chen ◽  
Chen-Wei Huang ◽  
Lung-Kun Yeh ◽  
Fang-Chi Hsiao ◽  
Yi-Jen Hsueh ◽  
...  
Keyword(s):  
Endothelial Cell ◽  
Cell Density ◽  
Corneal Thickness ◽  
Operation Time ◽  
Cell Loss ◽  
Endothelial Cell Density ◽  
Chang Gung Memorial Hospital ◽  
Cross Sectional ◽  
Group A ◽  
Group B

By evaluating preoperative endothelial cell density (ECD), ECD loss after phacoemulsification can be predicted. In this retrospective cross-sectional study, we compared outcomes of phacoemulsification with different levels of preoperative ECD. Three-hundred-and-fifty-three patients aged between 18 and 90 years received phacoemulsification at Chang Gung Memorial Hospital. Age (p = 0.003), preoperative logMAR (p = 0.048), cataract grade (p = 0.005), preoperative ECD (p < 0.001), operation time (p = 0.043), phacoemulsification time (p = 0.001), and phacoemulsification energy (p < 0.001) were significantly associated with postoperative ECD change (%). Patients were divided into three groups according to preoperative ECD levels. Level of ECD, coefficient of variation (CV), cell hexagonality (HEX), central corneal thickness (CCT), visual acuity, underlying diseases, and complications were analyzed. With regard to groups, 29, 71, and 252 patients were respectively allocated into the markedly low (group A; ECD below 1000 cells/mm2), mildly low (group B; ECD between 1000 to 2000 cells/mm2), and normal (group C; ECD above 2000 cells/mm2) ECD level groups. The highest CV (40.8 ± 13.9%; p < 0.001) and lowest HEX (58.4 ± 14.6%; p < 0.001) were found in group A. Significant ECD loss was found in group B (28.9 ± 9.2%) as compared to group A (19.9 ± 5.4%) and C (15.0 ± 12.0%) (p < 0.001). No significant differences were found with regard to changes in CV (p = 0.941), HEX (p = 0.937), CCT (p = 0.346), and logMAR (p = 0.557) among the three groups. In conclusion, preoperative ECD level could be a novel predictive value for postoperative cell loss, which was the most prominent in mildly low ECD level group. Less phacoemulsification energy, earlier surgical intervention, or novel topical medications could be suggested for patients with an ECD range from 1000 to 2000 cells/mm2.

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