Journal ArticleDOI
Risk factors for corneal endothelial injury during phacoemulsification
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TLDR
The firmness of the nucleus is identified as the most significant risk factor for endothelial cell loss and mechanical contact with nuclear fragments is considered the principal cause of endothelial injury.Abstract:
Purpose: To determine the principal risk factors for corneal endothelial injury during phacoemulsification. Setting: Hayashi Eye Hospital, Fukuoka, Japan. Methods: We prospectively investigated 859 consecutive eyes of 800 patients who had had phacoemulsification surgery. The percentage of corneal endothelial cell loss at 3 months after surgery was quantitated using specular microscopy. The firmness of the nucleus was graded by Emery's classification prior to surgery. We selected nine variables that could be associated with endothelial injury. The univariate associations between the endothelial cell loss and these variables were evaluated using simple correlation coefficients. A multiple linear regression analysis was performed to identify independent predictors of endothelial cell loss. Results: In the simple regression analysis, older age, small pupil diameter, high nucleus grade, large nucleus, greater infusion volume, type of IOL implanted, and a greater amount of total emitted ultrasound energy were univariately associated with endothelial cell loss. In the multiple linear regression analysis, the best final model (R2 = 0.42) identified high nucleus grade, greater infusion volume, type of IOL implanted, and large nucleus as independent predictors of endothelial cell loss. Conclusion: Both univariate and multivariate analyses identified the firmness of the nucleus as the most significant risk factor for endothelial cell loss. Therefore, mechanical contact with nuclear fragments is considered the principal cause of endothelial injury.read more
Citations
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Journal ArticleDOI
Anatomy and physiology of the cornea
Derek W. DelMonte,Terry Kim +1 more
TL;DR: The cornea lacks the neurobiological sophistication of the retina and the dynamic movement of the lens; yet, without its clarity, the eye would not be able to perform its necessary functions.
Journal ArticleDOI
Endothelial cell loss after phacoemulsification: relation to preoperative and intraoperative parameters
TL;DR: The location of corneoscleral incisions for phacoemulsification can be chosen according to the preoperative astigmatism without inducing additional adverse effects on the corneal endothelium.
Journal ArticleDOI
Effect of cataract surgery on the corneal endothelium: Modern phacoemulsification compared with extracapsular cataract surgery
Rupert R A Bourne,Darwin C Minassian,John K G Dart,John K G Dart,Paul Rosen,Sundeep Kaushal,Nicholas Wingate +6 more
TL;DR: In this paper, the authors investigated whether modern phacoemulsification surgery results in more damage to the corneal endothelium than extracapsular cataract extraction (ECCE).
Journal ArticleDOI
Corneal endothelial cell loss and corneal thickness in conventional compared with femtosecond laser–assisted cataract surgery: Three-month follow-up
TL;DR: The femtosecond laser did not add to the endothelial damage caused by cataract surgery and might be beneficial in eyes with low preoperative endothelial cell values (eg, cornea guttata cases).
Journal ArticleDOI
Femtosecond laser-assisted cataract surgery.
TL;DR: This article outlines the advantages of femtosecond laser cataract surgery and provides an initial comparison of the LensAR, LenSx/Alcon, and OptiMedica systems and early clinical results.
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Endothelial damage associated with intraocular lenses.
TL;DR: There was a severe loss of endothelial cells postoperatively in all five patients despite clear, thin corneas and there was no significant endothelial regeneration (increased number of cells) or continued cell loss during 15 weeks of postoperative observation.
Journal ArticleDOI
Intraocular Irrigating Solutions: Their Effect on the Corneal Endothelium
TL;DR: The effects of several intraocular irrigating solutions on the corneal endothelium of rabbit and monkey corneas were evaluated, utilizing a specular microscope perfusion system with both scanning and transmission electron microscopy.
Journal ArticleDOI
Frown incision for minimizing induced astigmatism after small incision cataract surgery with rigid optic intraocular lens implantation
TL;DR: Results suggest that the frown incision may provide many of the benefits of a 4 mm scleral pocket incision for flexible optic lenses and had a higher degree of linear dependence of postoperative astigmatism on preoperative astigma.
Journal Article
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E Kaufman,J I Katz +1 more
TL;DR: This work has shown that momentary contact between the methacrylate surface and the endothelial cells causes an adhesion between these surfaces and results in extensive cell damage upon separation of the surfaces.
Journal ArticleDOI
The Correlation between Incision Size and Corneal Shape Changes in Sutureless Cataract Surgery
TL;DR: The 3.2-mm incision hardly produced any irreversible corneal shape changes, whereas both the 4.0- and 5.0 -mm incisions caused a persistent irregular steepening in the central cornea.