The Effect of Phacoemulsification on Corneal  Endothelial Cells Morphology and Thickness

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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The Effect of Diabetes Mellitus on Corneal Endothelial Cells and Central Corneal Thickness: A Case-Control Study

Ophthalmic Research ◽

10.1159/000507197 ◽

2020 ◽

Vol 63 (6) ◽

pp. 550-554

Author(s):

Panagiota Papadakou ◽

Irini Chatziralli ◽

Miltiadis Papathanassiou ◽

Vaia Lambadiari ◽

Charalambos S. Siganos ◽

...

Keyword(s):

Diabetes Mellitus ◽

Diabetic Retinopathy ◽

Endothelial Cell ◽

Cell Density ◽

Corneal Endothelium ◽

Central Corneal Thickness ◽

Corneal Thickness ◽

Endothelial Cell Density ◽

Corneal Endothelial Cells ◽

Factors Affecting

Purpose: The aim of this study was to evaluate the characteristics of corneal endothelial cells and central corneal thickness (CCT) in patients with diabetes mellitus (DM), comparing them with those of healthy subjects (controls) and to determine potential factors affecting the corneal parameters in patients with DM. Methods: Participants in this study were 72 patients with DM and 88 healthy controls. Diabetic patients were further classified into groups depending on the severity of diabetic retinopathy (no retinopathy, mild, moderate, severe non-proliferative diabetic retinopathy, and proliferative diabetic retinopathy). All participants underwent non-contact specular microscopy to evaluate corneal endothelium parameters and CCT, while factors affecting endothelial cell density and CCT in patients with DM were also analyzed. Results: Patients with DM presented significantly decreased endothelial cell density compared to controls (2,297.9 ± 311.3 and 2,518.3 ± 243.7 cells/mm2, respectively; p < 0.001), while the two groups did not differ significantly in any other measured corneal parameter. In the diabetic group, the multivariate analysis showed a significant association between decreased endothelial cell density and increased HbA1c (p < 0.001), longer DM duration (p = 0.003), and more severe diabetic retinopathy status (p = 0.008). Conclusion: DM seems to affect the corneal endothelium, since endothelial cell density was decreased in the diabetic group, while duration of disease, HbA1c levels, and severity of retinopathy were significantly associated with changes in endothelial cell density and should be taken into account.

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Study of Changes in Corneal Thickness and Corneal Endothelial Cell Density after Phacoemulsification Cataract Surgery

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2021/187 ◽

2021 ◽

Vol 10 (12) ◽

pp. 866-872

Author(s):

Rajiv Pardasani ◽

Sohan Lohiya

Keyword(s):

Endothelial Cell ◽

Cell Density ◽

Coefficient Of Variation ◽

Central Corneal Thickness ◽

Corneal Thickness ◽

Cell Loss ◽

Corneal Endothelial Cell ◽

Endothelial Cell Density ◽

P Value ◽

Corneal Endothelial Cell Density

BACKGROUND Phacoemulsification is a common surgery for cataract. The endothelium comprises of hexagonal cells which in single layer is essential for maintaining the transparency of the cornea. We wanted to compare endothelial cell density (ECD), central corneal thickness (CCT), coefficient of variability, and hexagonality of endothelial cells before and after phacoemulsification surgery. we also wanted to evaluate the endothelial cell loss after phacoemulsification surgery. METHODS A rural hospital-based prospective observational study with 120 patients was conducted in a hospital based setting utilising the data of patient’s eye by considering inclusion and exclusion criteria, before and after phacoemulsification surgery by using noncontact specular microscope. RESULTS The mean endothelial cell density significantly decreased postoperatively at day one, 4th week, 12th week. The mean central corneal thickness increased significantly at postoperative day one, then subsequently decreased at postoperative 4th week and 12th week (P value = 0.0001), but never reached the preoperative value. There was a significant change in coefficient of variation and hexagonality postoperatively (P value = 0.0001). CONCLUSIONS The primary result is the change in corneal endothelial cell density (cells per square millimetre of the corneal surface) which is decreased, and the central corneal thickness calculated in micro meter is increased. As endothelial cells do not replicate, to reimburse cell loss there are changes in coefficient of variation and hexagonality after phacoemulsification surgery. KEY WORDS Corneal Endothelial Cell Density, Central Corneal Thickness, Coefficient of Variation, Hexagonality, Phacoemulsification, Specular Microscope

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Corneal thickness, endothelial cell density, and morphological and morphometric features of corneal endothelial cells in goats

American Journal of Veterinary Research ◽

10.2460/ajvr.79.10.1087 ◽

2018 ◽

Vol 79 (10) ◽

pp. 1087-1092 ◽

Cited By ~ 2

Author(s):

Natalia Coyo ◽

Marta Leiva ◽

Daniel Costa ◽

José Rios ◽

Teresa Peña

Keyword(s):

Endothelial Cells ◽

Endothelial Cell ◽

Cell Density ◽

Corneal Thickness ◽

Endothelial Cell Density ◽

Corneal Endothelial Cells ◽

Morphometric Features

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A Comparative Study of Central Corneal Thickness and Endothelial Cell Density after Phacoemulsification by ‘Phaco-chop’ and ‘Divide and Conquer’ Techniques

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2020/45010.14065 ◽

2020 ◽

Author(s):

Madhumita Prasad ◽

V Sachin Daigavane

Keyword(s):

Endothelial Cell ◽

Cell Density ◽

Central Corneal Thickness ◽

Corneal Thickness ◽

Endothelial Cell Density ◽

Divide And Conquer ◽

P Value ◽

Group A ◽

The Mean ◽

Group B

Introduction: Phacoemulsification was introduced by Kelman in 1967. It is one of the most important innovations in ophthalmology. This has now been accepted as gold standard surgical procedure for management of cataract. Divide and conquer technique, described by Gimbel, was the first nucleofractis cracking technique developed. Phoc-chop technique was presented by Kunihiro Nagahara in 1993 at the meeting of America Society of Cataract and Refractive Surgery. Aim: To compare the Central Corneal Thickness (CCT) and endothelial cell density after phacoemulsification by ‘phaco-chop’ and ‘divide and conquer’ techniques. Materials and Methods: The study included 100 patients divided into two groups, each including 50 patients; Group A, where Divide and Conquer was performed, and in Group B Phaco-chop was performed. The mean Absolute PhacoTime (APT), mean Endothelial Cell Count (ECC), mean Endothelial Cell Loss (ECL), corneal thickness and the visual acuity were reported in the two groups both preoperative and postoperative. Results: The mean APT in group A was 27.12±10.15 seconds, and in group B was 16.58±5.11 seconds (p=0.0001). The mean ECC at sixth week postoperative in group A was 2102. 14 cells/mm2 and in group B it was 2365.38 cells/mm2 (p=0.003). There was statistically significant ECL following sixth week postoperatively 16.22% in divide and conquer group and 8.51% in phaco-chop group (p-value=0.0001). A significant increase in the CCT was observed at the immediate postoperative week among the two studied groups; 3.16% in group A and 2.34% in group B, which was statistically significant. The postoperative CCT pachymetry values were returned to near preoperative values at one and a half months postoperative. Conclusion: The phaco-chop technique utilises less phaco time and energy without significant effect on the final surgical outcome. Significant and equal ECL occurs after the two studied techniques. APT and nuclear grade have a positive correlation with higher ECL. CCT increases significantly and equally postoperatively following the two techniques.

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Endothelial Cell Density and Central Corneal Thickness following Penetrating Keratoplasty of Acanthamoeba Keratitis Patients – A Retrospective Cross-Sectional Observational Study

Klinische Monatsblätter für Augenheilkunde ◽

10.1055/a-1353-5171 ◽

2021 ◽

Author(s):

Lei Shi ◽

Fabian Norbert Fries ◽

Kassandra Xanthopoulou ◽

Tanja Stachon ◽

Loay Daas ◽

...

Keyword(s):

Endothelial Cell ◽

Observational Study ◽

Cell Density ◽

Central Corneal Thickness ◽

Penetrating Keratoplasty ◽

Corneal Thickness ◽

Acanthamoeba Keratitis ◽

Endothelial Cell Density ◽

Cross Sectional ◽

Time Point

Abstract Purpose To analyze endothelial cell density (ECD) and central corneal thickness (CCT) following penetrating keratoplasty (PKP) in Acanthamoeba keratitis (AK) patients. Patients and Methods In this retrospective, clinical, single-center, cross-sectional, observational study, patients were enrolled who underwent PKP at the Department of Ophthalmology of Saarland University Medical Center, Homburg/Saar, Germany between May 2008 and December 2016 with the diagnosis of AK. In all, 33 eyes of 33 patients (14 males, 42%) were enrolled; their mean age at the time of surgery was 39.5 ± 14.3 years. Postoperatively, AK patients received topical polyhexamethylene biguanide, propamidine isethionate, neomycin sulphate/gramicidin/polymixin B sulfate, and prednisolone acetate eye drops (5 ×/day each), and the topical treatment was tapered sequentially with 1 drop every 6 weeks over 6 months. CCT was recorded using Pentacam HR Scheimpflug tomography and ECD with the EM-3000 specular microscope before surgery and 3 and 6 months after surgery as well as after the first and second (complete) suture removal. Results ECD tended to decrease significantly from the time point before surgery (2232 ± 296 cells/mm2) to the time point 3 months after surgery (1914 ± 164 cells/mm2; p = 0.080) and to the time point after the first suture removal (1886 ± 557 cells/mm2; p = 0.066) and decrease significantly to the time point after the second suture removal (1650 ± 446 cells/mm2; p = 0.028). CCT did not change significantly over the analyzed time period (p ≥ 0.475). Conclusion In AK, endothelial cell loss does not seem to be accelerated following PKP, despite the postoperative use of diamidine and biguanide. A subsequent prospective comparative study should confirm our retrospective longitudinal analysis.

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A novel human donor cornea preservation cocktail incorporating a thermo-reversible gelation polymer (TGP), enhancing the corneal endothelial cell density maintenance and explant culture of corneal limbal cells

Biotechnology Letters ◽

10.1007/s10529-021-03116-y ◽

2021 ◽

Author(s):

Bhuvaneshwari Namitha ◽

Munusamy Rajendran Chitra ◽

Mathevan Bhavya ◽

Periasamy Parikumar ◽

Shojiro Katoh ◽

...

Keyword(s):

Endothelial Cell ◽

Cell Density ◽

Corneal Thickness ◽

Explant Culture ◽

Endothelial Cell Density ◽

P Value ◽

Specular Microscopy ◽

Human Donor ◽

Corneal Preservation

Abstract Purpose McCarey-Kaufman’s (MK) medium and Optisol-GS medium are the most commonly employed media for human donor corneal preservation. In this study, we evaluated the preservation efficacy of discarded human donor corneas using a Thermo-reversible gelation polymer (TGP) added to these two media. Methods Thirteen human corneal buttons collected from deceased donors, which were otherwise discarded due to low endothelial cell density (ECD) were used. They were stored in four groups: MK medium, MK medium with TGP, Optisol-GS and Optisol-GS with TGP at 4 °C for 96 h. Slit lamp examination and specular microscopy were performed. Corneal limbal tissues from these corneas were then cultured using explant methodology one with and the other without TGP scaffold, for 21 days. Results MK + TGP and Optisol-GS + TGP preserved corneas better than without TGP, which was observed by maintenance of ECD which was significantly higher in Optisol-GS + TGP than MK + TGP (p-value = 0.000478) and corneal thickness remaining the same for 96 h. Viable corneal epithelial cells could be grown from the corneas stored only in MK + TGP and Optisol-GS + TGP. During culture, the TGP scaffold helped maintain the native epithelial phenotype and progenitor/stem cell growth was confirmed by RT-PCR characterization. Conclusion TGP reconstituted with MK and Optisol—GS media yields better preservation of human corneal buttons in terms of relatively higher ECD maintenance and better in vitro culture outcome of corneal limbal tissue. This method has the potential to become a standard donor corneal transportation-preservation methodology and it can also be extended to other tissue or organ transportation upon further validation.

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Endothelial cell density and characterization of corneal endothelial cells in the Tawny Owl (Strix aluco ) using specular microscopy

Veterinary Ophthalmology ◽

10.1111/vop.12578 ◽

2018 ◽

Vol 22 (2) ◽

pp. 177-182

Author(s):

Natàlia Coyo ◽

Marta Leiva ◽

Daniel Costa ◽

Rafael Molina ◽

Olga Nicolás ◽

...

Keyword(s):

Endothelial Cells ◽

Endothelial Cell ◽

Cell Density ◽

Endothelial Cell Density ◽

Specular Microscopy ◽

Corneal Endothelial Cells ◽

Tawny Owl ◽

Strix Aluco

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Corneal thickness and endothelial cell density in diabetic and non- diabetic patients: a hospital based comparative study

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20182125 ◽

2018 ◽

Vol 5 (3) ◽

pp. 694 ◽

Cited By ~ 1

Author(s):

Nagaraj G. ◽

Anasuya Sangaraj Desai ◽

Nagesh Jayaram

Keyword(s):

Endothelial Cell ◽

Cell Density ◽

Central Corneal Thickness ◽

Corneal Thickness ◽

Endothelial Cell Density ◽

Diabetic Group ◽

Control Group ◽

Diabetic Patients ◽

Specular Microscopy ◽

The Mean

Background: Diabetes mellitus is associated with structural changes in corneal endothelial cells and their thickness. The present study was done to compare the endothelial cell density (ECD), central corneal thickness (CCT) and morphology in diabetic and non-diabetic patients.Methods: A cross-sectional study was conducted at Minto Ophthalmic hospital, BMC and RI Bangalore for a period of 20 months (October 2013 - May 2015). A total of 200 study subjects, 100 diabetics and 100 non-diabetic age matched controls were selected, and complete timed ophthalmic evaluation was performed. Specular microscopy was performed on all patients for endothelial cell count assessment and corneal thickness was measured by Pachymeter. The data was analyzed and represented using descriptive statistics. ‘t’ test was used for comparing the two groups.Results: The mean endothelial cell density in diabetic group was significantly lower (2438.73±250.23cells/mm2) compared to non-diabetic group (2599.88±168.16cells/mm2) (p<0.0001). The mean Central corneal thickness in diabetic group was significantly higher (518.40±28.13 μm) compared to control group (490.14±24.31 μm) (p<0.001). The Co-efficient of variation percentage of the diabetics was higher than the non-diabetics but this difference was not statistically significant (P>0.05). The hexagonality percentage was significantly lower in diabetic group compared to the controls suggesting less pleomorphism in the diabetic group.Conclusions: The study concludes that the endothelial cell density was lower and central corneal thickness was higher in diabetic patients compared with the non-diabetics. The altered endothelial morphology was significantly seen in the form of pleomorphism (hexagonality) but polymegathism was not significantly altered.

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Corneal Thickness and Endothelial Morphology in Normal Thai Eyes

10.21203/rs.2.21265/v1 ◽

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.

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