Changes in corneal thickness and corneal endothelial cell density after phacoemulsification cataract surgery: a double-blind randomized trial
Journal Title: Electronic Physician - Year 2018, Vol 10, Issue 4
Abstract
BACKGROUND: Age-related cataract is a leading cause of visual impairment, considered a global health burden, it is responsible for over 47% of blindness worldwide. Surgical intervention is usually the treatment of choice and phacoemulsification cataract surgery with implantation of an intraocular lens is the most common procedure, which may have several complications. OBJECTIVES: To determine the effects of phacoemulsification surgery on corneal endothelial cell density and corneal thickness in patients undergoing cataract surgery. METHODS: The present study was conducted on patients diagnosed with immature senile cataract requiring surgical intervention from November 2013 to 2014 in Khatam al Anbia Hospital (a tertiary ophthalmology center). Physical examination included best-corrected visual acuity using the Snellen chart, refraction, slit-lamp bio-microscopy for anterior chamber evaluation, keratometry, Goldman tonometry, gonioscopy, and dilated indirect ophthalmoscopy, pachymetry, specular microscopy and biometry. Surgery was performed by similar method and technique in all patients. The change in the corneal endothelial cell count or density and central corneal thickness (CCT) number were compared preoperatively and one day, one week, one month, and three months post-operatively. RESULTS: A total of 92 eyes of 85 patients (43 females and 42 males with mean age of 62.1±12.2 years) were studied. Patients' visual acuity improved (log MAR: 1±0.5 preoperatively to 0.45±0.34 post-operatively) (p=0.001). There was 11.4% endothelial cell loss (ECL) and significant decrease in ECC (from 2,791.15±99.86 to 2,472.87±472.14) (p=0.04). The central corneal thickness increased significantly (from 530.47±2.60 to 540.91±36.07). Diabetic patients (12.9%) had a statistically significant higher ECL rate after phacoemulsification (14.6% versus 8.7% respectively, p=0.002). CONCLUSION: Phacoemulsification resulted in significant corneal endothelial damage, which is particularly important in patients with a borderline reservoir of endothelial cell, such as diabetic patients, which highlights the necessity of refining the current surgical methods and instruments to minimize the endothelial damage. TRIAL REGISTRATION: The trial was registered in the Thai clinical trial registry (http://www.clinicaltrials.in.th) with the ID: TCTR20171122001. FUNDING: The study was supported by a research grant of Mashhad University of Medical Sciences
Authors and Affiliations
Shahram Bamdad, Alireza Bolkheir, Mohammad Reza Sedaghat, Mahsa Motamed
Keywords
Related Articles
- EP ID EP339643
- DOI 10.19082/6616
- Views 102
- Downloads 0
The role of stem cells in the improvement of brain injuries after hypoxic ischemia
Introduction: Nowadays, the important role of stem cells in treatment of many diseases such as stoke is well known. Stem cells derived from either bone marrow or cord bloods are good sources for tissues replacement after...
The Effectiveness of Group Cognitive Behavioral Therapy in Treating Obsessive-Compulsive Disorder in Women with Multiple Sclerosis (MS): A randomized double-blind controlled trial
BACKGROUND: Obsessive-compulsive disorder (OCD) is one of the most prevalent psychiatric disorders and can cause problems for individuals in all aspects of life, including social and personal dimensions. OBJECTIVE: To s...
Correlation between Grades in the Medical Basic Science Course and Scores on the Comprehensive Basic Sciences Exam in Iran
Introduction: Medical students in Iran are required to undertake a Basic Sciences Comprehensive Exam (BSCE) at the end of their BS course in order to progress to the next stage of medical education. BSCE results are wi...
Langerhans Cell Histiocytosis (LCH) and Diabetes Insipidus with Mandibular lesion
Langerhans cell histicytosis (LCH) is a rare disorder that primarily affects children. Its occurrence in adult is very rare. We report a case of 42 year old female patient who presented polyuria and polydipsia, loo...
The Effect of Prophylactic Antibiotics on Post Laparoscopic Cholecystectomy Infectious Complications: A Double-Blinded Clinical Trial
BACKGROUND: Laparoscopic cholecystectomy (LC) is one of the most common surgeries in laparoscopic surgery. Although, it is believed that LC has low-risk for post-operative infectious complications, the use of a prophylac...