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Published on: April 24, 2020
Comparative Analysis of Corneal Endothelial Cell Loss After Phacoemulsification in Microcornea versus Normal-Sized
Tianyu Zheng1, Peimin Lin2,3,4, Ao Miao2,3,4
1Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China.
Background:
Phacoemulsification is inevitably accompanied by loss of corneal endothelial cells, and microcornea eyes with crowded anterior segments may be more susceptible to this damage.
Purpose:
This study aimed to compare endothelial cell loss (ECL) after cataract phacoemulsification surgery between eyes with microcornea and those with normal-sized corneas.
Methods:
This retrospective study included 50 eyes from 50 patients with microcornea and 120 eyes from 120 patients with normal-sized corneas who underwent phacoemulsification. Demographic data and biometric parameters were evaluated preoperatively. Postoperative corneal endothelial cell parameters were measured 3 months after surgery.
Results:
Compared with the normal controls, the microcornea group had a shallower anterior chamber, thicker lens and shorter white-to-white distance (WTW) (P < 0.01). Additionally, at 3 months postoperatively, the microcornea group had significantly greater ECL (662.20 ± 496.79 cells/mm2) than the control group did (360.53 ± 364.29 cells/mm2) (P < 0.001). The increase in the mean cell area in the microcornea group (185.38 ± 144.04 μm2) was significantly greater than that in the control group (75.56 ± 92.48 μm2) (P < 0.001). Multiple regression analysis revealed that WTW (Beta=-0.330, P<0.001) and average phaco energy (Beta=0.288, P=0.030) were significant determinants of postoperative ECL in patients with normal-sized corneas. WTW was also a statistically significant risk factor for ECL in all patients (Beta=-0.331, P<0.001).
Conclusion:
Compared with normal-sized corneas, microcorneas were more prone to endothelial cell loss after phacoemulsification. WTW was a significant risk factor for postoperative ECL. Preoperative measurement of WTW may serve as a useful risk stratification tool to identify patients who may require additional endothelial protective measures during cataract surgery.
