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Endothelial damage with cataract surgery techniques.

D Díaz-Valle·J M Benítez del Castillo Sánchez·A Castillo·O Sayagués·M Moriche
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Abstract

PURPOSE: To evaluate intraoperative endothelial damage after planned extracapsular cataract extraction (ECCE) with difference capsulotomy techniques and phacoemulsification. SETTING: San Carlos University Hospital, Castroviejo Institute, Madrid, Spain. METHODS: In this prospective, randomized study, 60 patients with senile cataract scheduled for cataract surgery were divided into three groups of 20 each: Group 1 had phacoemulsification; Group 2, planned ECCE with continuous curvilinear capsulorhexis; and Group 3, ECCE with letter-box capsulotomy. Preoperatively and 3 months postoperatively, endothelial cell density, percentage of hexagonality, and the cell size variation coefficient were determined by contact specular microscopy; endothelial permeability was examined by anterior segment fluorophotometry and central corneal thickness, by ultrasonic pachymetry. Results were analyzed using the two-tailed Student's t-test and analysis of variance. RESULTS: In all three groups, endothelial permeability and cell loss increased significantly from the preoperative values, but there were not significant differences among the postoperative values. Mean cell loss was 11.8% in Group 1, 12.8% in Group 2, and 10.1% in Group 3. There were no differences between the preoperative and postoperative morphometric indexes. Postoperative pachymetric measurements were not significant. CONCLUSIONS: Endothelial response was not statistically significantly different among the surgical techniques, although endothelial damage was lower in Group 3, which could indicate a protective effect of the anterior capsule during cataract extraction. Endothelial barrier function remained disturbed despite the apparent morphological stabilization.

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AgedCapsulorhexisCell CountCell SizeCell SurvivalEndothelium, CornealEye InjuriesFemaleFluorophotometryHumansIntraoperative ComplicationsLens Implantation, IntraocularLenses, IntraocularMaleMiddle AgedPermeabilityPhacoemulsificationPolymethyl MethacrylateProspective StudiesClinical TrialComparative StudyJournal ArticleRandomized Controlled Trial

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D Díaz-Valle, J M Benítez del Castillo Sánchez, A Castillo, O Sayagués, M Moriche. 1998. Endothelial damage with cataract surgery techniques.. https://doi.org/10.1016/s0886-3350(98)80049-7

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