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

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.

scholarly journals The Effect of Phacoemulsification on Corneal Endothelial Cells Morphology and Thickness

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Abd Elaziz Mohamed Elmadina ◽  
Raghda Faisal Abdelfatah ◽  
Saif Hassan Alrasheed ◽  
Mustafa Abdu ◽  
Manzoor Ahmad Qureshi
Keyword(s):  
Endothelial Cells ◽  
Endothelial Cell ◽  
Cell Density ◽  
Corneal Endothelium ◽  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Endothelial Cell Density ◽  
P Value ◽  
Corneal Endothelial Cells ◽  
Before And After

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.

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

2018 ◽  
Vol 5 (3) ◽  
pp. 694 ◽  
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.

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

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

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.

scholarly journals Femtoszekundumlézeres keratoplasztika

2018 ◽  
Vol 159 (17) ◽  
pp. 671-676
Author(s):  
László Módis ◽  
Eszter Szalai ◽  
Zsuzsanna Flaskó ◽  
Bence Kolozsvári ◽  
András Berta
Keyword(s):  
Endothelial Cell ◽  
Femtosecond Laser ◽  
Cell Density ◽  
Central Corneal Thickness ◽  
Penetrating Keratoplasty ◽  
Corneal Thickness ◽  
Endothelial Cell Density ◽  
Significant Difference ◽  
The Mean

Abstract: Introduction and aim: To present our results on femtosecond laser-assisted penetrating keratoplasty. Patients and method: Twenty-five eyes of 25 patients underwent surgery with the following indications: pseudophakic bullous keratopathy (n = 10), keratoconus (n = 4), corneal dystrophy (n = 5), corneal scar (n = 4), band keratopathy (n = 2). Trephination of both the donor and recipient corneas were performed with VisuMax femtosecond laser device (Carl Zeiss Meditec AG, Jena, Germany). In each case, trephinaton of the donor tissue was performed first with an artificial anterior chamber (Moria, Antony, France). For the surgical plan and in the postoperative period we obtained different corneal imaging modalities. The corneal power was measured with corneal topography (TMS-4, Tomey, Nürnberg, Germany) and Scheimpflug tomography (Pentacam HR, Oculus, Wetzlar, Germany). The central corneal thickness was evaluated with Pentacam and corneal endothelial cell density was measured with specular microscopy (SP3000P, Topcon, Tokyo, Japan). The corneal structure was imaged with anterior segment optical coherence tomography (Visante, Carl Zeiss Meditec AG). All measurements were performed every 3 months in the first year and yearly thereafter. The follow-up period was 3 years in every case. Results: The corrected decimal visual acuity showed an improvement from a preoperative 0.1 ± 0.1 to a postoperative 0.71 ± 0.18 value at the end of the follow-up period (p = 0.03). All corneal grafts maintained their transparency, there were no immunological rejection during the follow-up. Topographical astigmatism was 4.5 ± 3.1 D in the first month; it showed a decreasing tendency, but there was no significant change in the 3-year period. The mean central corneal thickness changed with 60 µm during the follow-up; there was no significant difference between the first month (564 ± 52 µm) and the third year (596 ± 64 µm) mean pachymetry values (p = 0.1). The mean endothelial cell density decreased first, then remained stable, but did not change significantly from the first (1641 ± 433 cells/mm2) to the last postoperative visit (1220 ± 391 cells/mm2, p = 0.1). Conclusions: In the case of femtosecond laser-assisted penetrating keratoplasty, trephination of the donor and recipient cornea is performed automatically in a highly precise fashion. The accurate cutting surface provides excellent wound apposition and healing. Both anatomical and functional rehabilitation of patients undergoing surgery are favourable and fast. Orv Hetil. 2018; 159(17): 671–676.

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 and Analysis 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/mm 2 , 37.61 ± 6.76%, 369.04 ± 37.90 μm, and 49.03% ± 7.53%, respectively. There was a statistically significant inverse correlation between age and CCT (r = -0.215, P <0.001), ECD (r = -0.496, P <0.001), and hexagonality (r = -0.265, P <0.001). The CV and CA directly correlated with age (r = 0.242, P <0.001 and r = 0.470, P <0.001).The estimate rate of endothelial cell loss was 0.2% per year. There was no correlation between CCT and ECD (P = 0.106). 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 did not correlate with the endothelial cell density.

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

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.

scholarly journals 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

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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