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Abstract #47715 Published in IGR 13-4
Outcomes of cataract surgery in eyes with a low corneal endothelial cell density
Yamazoe K; Yamaguchi T; Hotta K; Satake Y; Konomi K; Den S; Shimazaki JJournal of Cataract and Refractive Surgery 2011; 37: 2130-2136
Purpose: To evaluate the surgical outcomes of cataract surgery in eyes with a low preoperative corneal endothelial cell density (ECD) and analyze factors affecting the prognosis. Setting: Tokyo Dental College, Ichikawa General Hospital, Chiba, Japan. Design: Noncomparative case series. Methods: Eyes with a preoperative ECD of less than 1000 cells/mm(2) that had cataract surgery between 2006 and 2010 were identified. Standard phacoemulsification with intraocular lenses was performed using the soft-shell technique. The rate of endothelial cell loss, incidence of bullous keratopathy, and risk factors were retrospectively assessed. Results: Sixty-one eyes (53 patients) with a low preoperative ECD were identified. Preoperative diagnoses or factors regarded as causing endothelial cell loss included Fuchs dystrophy (20 eyes), laser iridotomy (16 eyes), keratoplasty (10 eyes), traumatic injury (3 eyes), trabeculectomy (3 eyes), corneal endotheliitis (2 eyes), and other (7 eyes). The corrected distance visual acuity improved from 0.59 (plus or minus) 0.49 logMAR preoperatively to 0.32 (plus or minus) 0.48 logMAR postoperatively (P<.001). The mean ECD was 693 (plus or minus) 172 cells/mm(2) and 611 (plus or minus) 203 cells/mm(2), respectively (P=.001). The mean rate of endothelial cell loss was 11.5% (plus or minus) 23.4%. Greater ECD loss was associated with a shorter axial length (AL) (<23.0 mm) and diabetes mellitus. Bullous keratopathy developed in 9 eyes (14.8%) and was associated with posterior capsule rupture. Conclusions: The results suggest that modern techniques for cataract surgery provide excellent visual rehabilitation in many patients with a low preoperative ECD. Shorter AL, diabetes mellitus, and posterior capsule rupture were risk factors for greater ECD loss and bullous keratopathy. Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (copyright) 2011 ASCRS and ESCRS.
K. Yamazoe. Departments of Ophthalmology, Tokyo Dental College, Ichikawa General Hospital, 5-11-13 Sugano, Ichikawa, Chiba 272-8513, Japan. Email: kyamazoe1528@yahoo.co.jp
Classification:
9.4.11.2 Glaucomas in aphakia and pseudophakia (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.11 Glaucomas following intraocular surgery)
2.2 Cornea (Part of: 2 Anatomical structures in glaucoma)
