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Corneal endothelial cell changes in pseudoexfoliation syndrome after cataract surgery
C Wirbelauer1, N Anders, D T Pham
1Augenklinik im Virchow-Klinikum, Medizinische Fakultät der Humboldt-Universität zu Berlin, Germany. cwirbelauer@pc2.ophtha.mu-luebeck.de
Objective:
To characterize possible differences in endothelial cell changes after cataract surgery in patients with pseudoexfoliation syndrome (PSX).
Methods:
In this prospective, age-matched, controlled clinical study, 25 consecutive patients with PSX and 25 control patients with senile cataracts only were studied. All patients were treated with standardized cataract surgery. Sequential quantitative and qualitative morphometric endothelial cell analyses of the central and paracentral cornea were performed preoperatively and postoperatively at 1 day, 4 weeks, and 6 months using noncontact specular microscopy.
Results:
Preoperative endothelial cell counts were 9.9% (P<.05) lower in patients with PSX (2387+/-266 cells/mm2) than in controls (2648+/-349 cells/mm2). The mean endothelial cell loss was 11.1% in the PSX group and 10.3% (P<.001 for both) in the control group, with no intergroup differences after 6 months. The mean endothelial cell area increased in both groups. Also, qualitative analysis revealed no significant differences in the endothelial repair mechanisms.
Conclusions:
Endothelial cell density is reduced preoperatively in patients with PSX compared with age-matched controls. In patients with PSX, cataract surgery induced similar endothelial cell changes without increased endothelial cell loss postoperatively.