Endothelial Cell Loss After Phacoemulsification in a Romanian Cohort: Early Outcomes and Associated Risk Factors

Area of Science:

• Ophthalmology
• Corneal Surgery
• Cataract Surgery

Background:

• Corneal endothelial damage is a significant concern after phacoemulsification.
• Quantifying early postoperative changes in endothelial cell density is crucial.

Purpose of the Study:

• To quantify early postoperative changes in endothelial cell density metrics after cataract surgery in a Romanian population.
• To identify preoperative and intraoperative predictors of endothelial cell loss.

Main Methods:

• Retrospective observational study of 137 eyes undergoing phacoemulsification.
• Specular microscopy assessed corneal endothelium preoperatively and at 1 week and 1 month postoperatively.
• Regression models analyzed associations between demographic, biometric, surgical variables, and endothelial changes.

Main Results:

• Mean endothelial cell density decreased significantly at 1 week and 1 month postoperatively.
• Shallower anterior chamber depth and lower baseline cell density were associated with lower postoperative density.
• Higher average ultrasound energy was linked to lower cell density at 1 week.

Conclusions:

• Phacoemulsification leads to significant early endothelial cell loss within the first postoperative month.
• Endothelial cell loss magnitude is influenced by preoperative anterior chamber depth and intraoperative ultrasound energy.
• Preoperative biometric assessment and intraoperative ultrasound minimization are recommended to reduce endothelial risk.