scholarly journals Corneal Endothelial Change after Phacoemulsification

2016 ◽  
Vol 6 (3) ◽  
pp. 134-39
Author(s):  
Md Abdus Salam Siddique
Keyword(s):  
Endothelial Cell ◽  
Cell Count ◽  
Cell Loss ◽  
Modern Method ◽  
Endothelial Cell Count ◽  
Cell Counts ◽  
Before And After ◽  
The Mean ◽  
Specular Microscope

Background: Phacoemulsification is the modern method of sight restoring surgery for cataract and it is becoming popular day by day. We planned this study to find out any significant cell loss during this procedure leading to corneal endothelial decompression.Objective: To compare the preoperative and postoperative cell counts after phacoemulsification surgery.Materials and Methods: This prospective study was carried out at the National Institute of Ophthalmology and Hospital, Dhaka from July to September, 2008 to see the corneal endothelial change after phacoemulsification. A total of 60 cases with lental opacity, who underwent phacoemulsification surgery, were studied with specular microscope. The endothelial cell count was measured with specular microscope before and after cataract surgery. Postoperative cases were followed up to one and half months after surgery. A single group of patients were studied and their preoperative and postoperative values were compared. The inclusion and exclusion criteria were maintained properly.Results: The mean preoperative endothelial cell count was 2745.35 ± 395.27 (SD) per mm2 which gradually decreased to 2545.23 ± 348.83 (SD) per mm2 at the end of one and half months after surgery; mean cell loss was 200.12 ± 46.44 (7.29%).Conclusion: This study reveals that a moderate loss of endothelial cell after phacoemulsification does not hamper the corneal transparency and visual function as depicted from visual acuity records in follow-up periods, provided the endothelium is healthy and the number is above the threshold limit.J Enam Med Col 2016; 6(3): 134-139

scholarly journals The kebab technique uses a bipolar pencil to retrieve a dropped nucleus of the lens via a small incision

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hiroshi Aso ◽  
Harumasa Yokota ◽  
Hirotsugu Hanazaki ◽  
Satoru Yamagami ◽  
Taiji Nagaoka
Keyword(s):  
Endothelial Cell ◽  
Cell Count ◽  
Acute Angle ◽  
Corneal Endothelial Cell ◽  
Angle Closure ◽  
Endothelial Cell Count ◽  
Small Incision ◽  
Before And After ◽  
Phacolytic Glaucoma ◽  
The Mean

AbstractWe developed a new method to retrieve a dropped nucleus of the lens via a small incision using bipolar pencils, the kebab technique, to solve the lack of small-gauge fragmatomes, and the expense and toxicity of perfluorocarbon liquids (PFCL). A total of 8 eyes in 6 patients underwent this technique and were reviewed. After vitrectomy, the dropped nucleus of the lens was lifted from the retina by adhesion with a bipolar pencil, and phacoemulsification was performed while rotating the lens. The outcome measures were best-corrected visual acuity (BCVA), intraocular pressure (IOP), and corneal endothelial cell density before and after surgery. Surgical indications included zonular weakness, trauma, acute angle closure attack, and phacolytic glaucoma. At 1 month, BCVA improved from a mean (standard deviation, SD) 1.67 logMAR (0.90) to 1.14 logMAR (1.01). The mean preoperative IOP was 24.5 (16.8) mmHg and postoperative IOP was 11.0 (2.8) mmHg. The mean preoperative corneal endothelial cell count was 2600 (322) cells/mm2 (one eye was unmeasurable) and postoperative corneal endothelial cell count was 2387 (431) cells/mm2. There were no postoperative complications. The retrieval of a dropped nucleus of the lens using a bipolar pencil enables small incisions without using PFCL.

scholarly journals The Kebab Technique: Using a Bipolar Pencil to Retrieve a Dropped Nucleus via a Small Incision

2020 ◽  
Author(s):  
Hiroshi Aso ◽  
Harumasa Yokota ◽  
Hirotsugu Hanasaki ◽  
Satoru Yamagami ◽  
Taiji Nagaoka
Keyword(s):  
Intraocular Pressure ◽  
Endothelial Cell ◽  
Cell Count ◽  
Acute Angle ◽  
Corneal Endothelial Cell ◽  
Angle Closure ◽  
Endothelial Cell Count ◽  
Small Incision ◽  
Before And After ◽  
The Mean

Abstract We developed a new method to retrieve a dropped nucleus via a small incision using bipolar pencils, the kebab technique, to solve the lack of small-gauge fragmatomes, and the expense and toxicity of perfluorocarbon liquids (PFCL). A total of 8 eyes in 6 patients underwent this technique and were reviewed. After vitrectomy, the dropped nucleus was lifted from the retina by adhesion with a bipolar pencil, and phacoemulsification was performed while rotating the lens. The outcome measures were best-corrected visual acuity (BCVA), intraocular pressure (IOP), and corneal endothelial cell density before and after surgery. Surgical indications included zonular weakness, trauma, acute angle closure attack, and phacolytic glaucoma. At 1 month, BCVA improved from a mean ± SD 1.67 logMAR (± 0.90) to 1.14 logMAR (± 1.01). The mean preoperative intraocular pressure (IOP) was 24.5 (± 16.8) mmHg and postoperative IOP was 11.0 (± 2.8) mmHg. The mean preoperative corneal endothelial cell count was 2600 (322) cells/mm2 (one eye was unmeasurable) and postoperative corneal endothelial cell count was 2387 (± 431) cells/ mm2. There were no postoperative complications. The retrieval of a dropped nucleus using a bipolar pencil enables small incisions without using PFCL.

scholarly journals Comparison of endothelial cell loss and complications between phacoemulsification and manual small incision cataract surgery (SICS) in uveitic cataract

2016 ◽  
Vol 7 (2) ◽  
pp. 124-134
Author(s):  
Rahul Bhargava ◽  
Shiv Kumar Sharma ◽  
Mini Chandra ◽  
Prachi Kumar ◽  
Yogesh Arora
Keyword(s):  
Endothelial Cell ◽  
Cataract Surgery ◽  
Cell Loss ◽  
Complication Rates ◽  
Endothelial Cell Loss ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Cell Counts ◽  
Endothelial Cell Counts

Introduction: Endothelial cell loss and complications after cataract surgery may be higher when cataract is complicated by uveitis.Objective: To compare endothelial cell damage and complication rates after phacoemulsification and manual small incision cataract surgery (SICS) in patients with uveitis.Materials and methods: Patients with uveitic cataract were randomly allocated for phacoemulsification (n=75) or manual SICS (n=80) in a double blind prospective study. In the bag implantation of a hydrophobic acrylic intraocular lens was aimed in all cases. Patients with follow up of less than six months were excluded. Main outcome measures were alteration in endothelial cell counts (ECC) and morphology, improvement in vision and complication rates. ECC was measured preoperatively and at 1 week, 3 months and six months, postoperatively.Results: Six patients were lost to follow up and another three due inability to implant IOL. There were no significant difference in endothelial cell counts (P= 0.032), the variance of endothelial cell size (CV) and percentage of hexagonal cells between both the groups at six months (Mann-Whitney test, P=0.283). Endothelial cell density was significantly less in the group in which vitrectomy and/or pupil dilatation procedures were performed (2290±31.5 cells/mm2) versus (2385±50.3 cells/mm2), respectively (t test, P<0.001). Incidence of postoperative complications that were observed like persistent uveitis (P=0.591), macular edema (P=0.671) and PCO (P=0.678) and visual outcome (P=0.974) were comparable between the two groups.Conclusions: Manual SICS and phacoemulsification do not differ significantly in endothelial cell loss and complication rates in uveitic eyes. However, increased anterior chamber manoeuvring due to additional procedures may lead to significantly higher endothelial cell loss.

scholarly journals Effect of donor and host factors on corneal graft transparency

2021 ◽  
Vol 6 (4) ◽  
pp. 56-61
Author(s):  
Dr. Amisha Jain ◽  
◽  
Dr. Hema Joshi ◽  
Dr. Nimish Jain ◽  
◽  
...  
Keyword(s):  
Endothelial Cell ◽  
Cell Count ◽  
Graft Survival ◽  
Graft Failure ◽  
Failure Group ◽  
Endothelial Cell Count ◽  
Donor Factors ◽  
Group 2 ◽  
Group 1

Objective: To study the correlation between donor factors and recipients' factors on graft clarity.Materials and methods: The study comprised 30 cases of Keratoplasty surgery with a follow up of6 months. All donor corneas were evaluated by Konan specular microscope for endothelial cellcount; details of the donor like age, cause of death were noted. The patients were divided into twogroups, Group 1 had graft failure, and Group 2 had clear corneas. Observation and Result: Therewere 12 patients in group 1 and 18 patients in group 2 with six months of follow up. The meanendothelial cell count in group 1 was 1942.3/mm2, and group 2 was 2334.8/mm2. There is asignificant difference in the mean endothelial cell count between the two groups. On analysing theindication for Keratoplasty in two groups, the outcome was best for the corneal opacity group duringworst for the graft failure group. Conclusion: Donor endothelial cell count significantly influencedgraft outcome; rest donor factors (age, death enucleation interval, enucleation surgery interval)don't affect graft survival. Indication for Keratoplasty is a significant predictor of graft survival.

The utility of contact lens-assisted corneal cross-linking (CACXL) in progressive keratoconus patients with thin corneas

2022 ◽  
pp. 112067212110709
Author(s):  
Bilgehan Sezgin Asena ◽  
Mahmut Kaskaloglu
Keyword(s):  
Visual Acuity ◽  
Endothelial Cell ◽  
Cell Count ◽  
Contact Lens ◽  
Corneal Thickness ◽  
Hydroxypropyl Methylcellulose ◽  
Cross Linking ◽  
Demarcation Line ◽  
Endothelial Cell Count ◽  
The Mean

Purpose To evaluate efficacy and safety of contact lens-assisted corneal cross-linking (CACXL) among progressive keratoconus patients with thin corneas. Setting Private eye hospital Design Cross-sectional study Methods Thirty-six eyes of 36 consecutive patients with progressive keratoconus and thinnest corneal thickness of 380–400 µm after epithelium removal were included. CACXL was performed based on use of a dextran-free isotonic (>0.1%) riboflavin solution with hydroxypropyl methylcellulose (HPMC, 1.1%) after epithelial removal and placement of a riboflavin-soaked contact lens without an ultraviolet filter on the cornea and ultraviolet irradiance. Data on best distance corrected (CDVA) and uncorrected (UDVA) visual acuity, manifest sphere (D), manifest cylinder (D), K1 (D), K2 (D), mean keratometry (D) and Kmax (D) values, endothelial cell count and mean depth of demarcation line were recorded preoperatively and at the postoperative 1-year Results Post-operative 1-year data revealed significant increases in UDVA (0.23  ±  0.15 vs. 0.17  ±  0.13 D, p < 0.001) and CDVA (0.44  ±  0.18 vs. 0.36  ±  0.17 D, p < 0.001) values and a significant reduction in the mean Kmax (from 56  ±  3.3D to 55  ±  3.2 D, p < 0.001), K2 (from 49.7  ±  3.2 D to 49.52  ±  3.11 D, p  =  0.049), manifest sphere (from −1.93  ±  2.21 D to −1.55  ±  2.02 D, p  =  0.001) and manifest cylinder (from −2.83  ±  1.67 D to −2.39  ±  1.36 D, p < 0.001) values along with a similar endothelial cell count. The mean depth of demarcation line was mean 230 (SD17.05, range 200 to 262) at postoperative 1-month. Conclusions Our findings indicate favourable 1-year postoperative outcome of CACXL in progressive keratoconus patients with thin cornea in terms of improved visual acuity and keratectasia status as well as endothelial safety.

scholarly journals Dispersive viscosurgical devices demonstrate greater efficacy in protecting corneal endothelium in vitro

2019 ◽  
Vol 4 (1) ◽  
pp. e000227 ◽  
Author(s):  
Timur Mert Yildirim ◽  
Gerd U Auffarth ◽  
Hyeck-Soo Son ◽  
Ramin Khoramnia ◽  
Donald John Munro ◽  
...  
Keyword(s):  
Endothelial Cell ◽  
Cell Count ◽  
Corneal Endothelium ◽  
In Vitro Study ◽  
Endothelial Cell Count ◽  
Cell Counts ◽  
Young Pigs ◽  
Endothelial Surface ◽  
Ophthalmic Viscosurgical Device

ObjectiveDuring phacoemulsification, the corneal endothelium is protected by an ophthalmic viscosurgical device (OVD). In this in vitro study, we assessed six different OVDs for their effectiveness in protecting the corneal endothelium.Methods and analysisPhacoemulsification was performed in cadaver eyes of young pigs. Five syringe units of six different OVDs were tested (Healon EndoCoat, Viscoat, Methylvisc, Healon, Healon GV, ProVisc). After surgery, the area of endothelium coated with OVD was determined in relation to the total endothelial surface. Additionally, an endothelial cell count was obtained. As a control, an endothelial cell count was obtained from freshly trephined corneas. Statistical analysis was performed using the Mann-Whitney U test and the Spearman correlation.ResultsThe least postoperative endothelial coating and cell count were observed in the cohesive OVDs while the dispersive OVDs showed statistically significant higher values. Healon EndoCoat and Viscoat yielded a coating area of 86 (85–92)% and 85 (85-90)%, respectively. Endothelial cell count was highest in the two dispersive groups with 4065 (3928–4088) cells/mm2 (Methylvisc) and 4032 (4015–4115) cells/mm2 (Viscoat). Endothelial coating area and endothelial cell count correlated statistically significantly.ConclusionDispersive OVDs from this study showed greater adherence to the endothelial surface than the cohesive ones. Furthermore, postoperative endothelial cell counts of corneas treated with dispersive OVDs were higher than of corneas treated with cohesive OVDs. Our in vitro results suggest that dispersive OVDs protect the corneal endothelium better during phacoemulsification than cohesive OVDs.

scholarly journals Long-term Clinical Outcomes of Implantable Collamer Lens

2021 ◽  
Vol 62 (8) ◽  
pp. 1043-1052
Author(s):  
Bu Ki Kim ◽  
Young Taek Chung
Keyword(s):  
Endothelial Cell ◽  
Retinal Detachment ◽  
Clinical Outcomes ◽  
Cell Loss ◽  
Efficacy And Safety ◽  
Implantable Collamer Lens ◽  
Significant Difference ◽  
The Mean

Purpose: To evaluate the long-term clinical outcomes of implantable collamer lens (ICL) implantation in myopic patients.Methods: This retrospective study included 129 eyes of 68 patients who underwent ICL implantation for correction of myopia with a 10-year follow-up.Results: Ten years after ICL implantation, the mean uncorrected and corrected distance visual acuities (LogMAR) were 0.03 ± 0.13 and -0.07 ± 0.06, respectively. Ten years postoperatively, 52.7% and 84.5% of the eyes were within ± 0.5 and ± 1.0 diopters, respectively. The mean efficacy and safety indices were 0.91 ± 0.22 and 1.07 ± 0.19, respectively. There was no significant difference between mean preoperative (13.52 ± 2.88 mmHg) and postoperative (13.59 ± 3.55 mmHg) intraocular pressures. The endothelial cell density decreased from before surgery to 10 years after surgery (3,074 ± 365 cells/mm2, 2,812 ± 406 cells/mm2, respectively; mean decrease: 8.5 ± 10.8%; p = 0.011). Eight eyes (6.2%) developed cataract during follow-up, which was symptomatic in three eyes (2.3%) and treated with ICL explantation and phacoemulsification. Rhegmatogenous retinal detachment occurred in one eye (0.8%) and was treated with vitrectomy.Conclusions: ICL implantation for the correction of myopia had good efficacy and safety outcomes during long-term follow-up of 10 years. However, patients should be closely monitored for complications such as cataract formation, endothelial cell loss, and retinal detachment.

scholarly journals Mean Corneal Endothelial Cell Loss in Type 2 Diabetic Cataract Patients After Phacoemulsification.

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Syed Abdullar Mazhar ◽  
Sehar Zahid ◽  
Junaid Hanif ◽  
Muhammad Asharib Arshad ◽  
Rana Naveed Iqbal
Keyword(s):  
Type 2 Diabetes ◽  
Endothelial Cell ◽  
Cell Count ◽  
Cell Loss ◽  
Corneal Endothelial Cell ◽  
P Value ◽  
Specular Microscopy ◽  
Endothelial Cell Loss ◽  
Endothelial Cell Count

Purpose:  To assess the mean corneal endothelial cell loss after Phacoemulsification in patients of type 2 diabetes. Study Design:  Cross-sectional study. Place and Duration of Study:  Layton Rahmatullah Benevolent Trust Free Eye and Cancer Hospital for a period of six months, from May 2015 to November 2015. Material and Methods:  Three hundred and fifty-five patients were selected by non-probability convenience sampling. Patients with cataract, diagnosed at least after 6 months of diagnosis of type 2 diabetes were included in this study. Patients with any systemic disease or ocular disease other than senile cataract were excluded from the study. Endothelial cell count was measured with Specular microscopy one day before surgery. One experienced surgeon with post-graduate experience of at least five years performed all the procedures. Follow up by specular microscopy was done at 6 weeks after phacoemulsification. Statistical analysis was done using SPSS version 23. Results:  Mean age of the patients was 59.32 ± 7.60 years. There were 41.97% males and 58.03% females. Mean endothelial cell count before phacoemulsification was 2177.21 ± 591.078 and 6 weeks after surgery was 1984 ± 597.51. Age, gender, laterality, duration of diabetes and type of cataract was not significantly related with endothelial cell loss, p-value > 0.05. Mean endothelial cells loss was higher in patients with HbA1c > 7 as compared to those with HbA1c < 7 (p-value = 0.01). Conclusion:  Patients with poor control of diabetes have higher endothelial cell loss after phacoemulsification than patients with good control.

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