Corneal thickness and endothelial density before and after cataract surgery

Area of Science:

• Ophthalmology
• Corneal Physiology
• Surgical Outcomes

Background:

• Corneal deturgescence relies on endothelial cell pumping, monitored by central corneal thickness (pachymetry).
• Endothelial cell loss can increase corneal thickness, potentially leading to decompensation and vision loss.
• The impact of moderate endothelial cell reduction on corneal stroma thickness is not well understood.

Purpose of the Study:

• To investigate the effect of moderate endothelial cell count reduction on corneal stroma thickness.
• To analyze changes in central corneal thickness and endothelial cell density following cataract surgery.

Main Methods:

• Central corneal thickness (CCT) measured pre-surgery, 1 day post-surgery, and at 3 months/1 year.
• Endothelial cell counts performed pre-surgery and at 3 months/1 year post-surgery.
• CCT measured using optical low coherence reflectometry and ultrasonic pachymetry; endothelial cell density estimated via specular microscopy.

Main Results:

• Postoperative corneal swelling resolved by 3-12 months, despite significant endothelial cell loss.
• No correlation found between central corneal thickness and endothelial cell numerical density.
• Optical low coherence reflectometry provided less variable and lower CCT measurements than ultrasonic pachymetry.

Conclusions:

• Moderate decreases in corneal endothelial cell density do not impair overall endothelial pumping function.
• Corneal stromal thickness is maintained as long as endothelial cell density remains above the physiological threshold.