Outcomes of cataract surgery in eyes with a low corneal endothelial cell density

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• 作者：Katsuya Yamazoe MD  ; ;   ; ^{kyamazoe1528@yahoo.co.jp} ; Takefumi Yamaguchi MD ; Kazuki Hotta MD ; Yoshiyuki Satake MD ; Kenji Konomi MD ; Seika Den MD ; Jun Shimazaki MD[Author vitae]
• 刊名：Journal of Cataract and Refractive Surgery
• 出版年：2011
• 出版时间：December 2011
• 年：2011
• 卷：37
• 期：12
• 页码：2130-2136
• 全文大小：148 K

文摘

Purpose

To evaluate the surgical outcomes of cataract surgery in eyes with a low preoperative corneal endothelial cell density (ECD) and analyze factors affecting the prognosis.

Setting

Tokyo Dental College, Ichikawa General Hospital, Chiba, Japan.

Design

Noncomparative case series.

Methods

Eyes with a preoperative ECD of less than 1000 cells/mm² that had cataract surgery between 2006 and 2010 were identified. Standard phacoemulsification with intraocular lenses was performed using the soft-shell technique. The rate of endothelial cell loss, incidence of bullous keratopathy, and risk factors were retrospectively assessed.

Results

Sixty-one eyes (53 patients) with a low preoperative ECD were identified. Preoperative diagnoses or factors regarded as causing endothelial cell loss included Fuchs dystrophy (20?eyes), laser iridotomy (16 eyes), keratoplasty (10 eyes), traumatic injury (3 eyes), trabeculectomy (3 eyes), corneal endotheliitis (2 eyes), and other (7 eyes). The corrected distance visual acuity improved from 0.59 ¡À 0.49 logMAR preoperatively to 0.32 ¡À 0.48 logMAR postoperatively (P<.001). The mean ECD was 693 ¡À 172 cells/mm² and 611 ¡À 203 cells/mm², respectively (P=.001). The mean rate of endothelial cell loss was 11.5 % ¡À 23.4 % . Greater ECD loss was associated with a shorter axial length (AL) (<23.0 mm) and diabetes mellitus. Bullous keratopathy developed in 9 eyes (14.8 % ) and was associated with posterior capsule rupture.

Conclusions

The results suggest that modern techniques for cataract surgery provide excellent visual rehabilitation in many patients with a low preoperative ECD. Shorter AL, diabetes mellitus, and posterior capsule rupture were risk factors for greater ECD loss and bullous keratopathy.

Financial Disclosure

No author has a financial or proprietary interest in any material or method mentioned.