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First Author: N.Lutsenko UKRAINE
Co Author(s): O. Isakova N. Zavgorodnyaya O. Rudycheva
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To compare corneal endothelium morphometric characteristics of different age patients before and after phacoemulsification with IOL.
State Institution "Zaporizhya Medical Academy of Postgraduate Education Ministry of Public Health"
Different age patients from 35 to 92 years with cataract were assigned to have phacoemulsification. The main outcomes included central corneal thickness (CCT), central endothelial cell density (ECD), minimum, maximum and average size of endothelial cells, coefficient of variation of cells, percentage of hexagonal cells, ultrasound time, cumulative dissipated energy (CDE), balanced salt solution volume. Postoperative follow-up was at 1 day, 1 week and 1 month. All patients were divided into 5 groups depending on the age: group 1st up to 50 years (8 eyes), 2d group 51-60 years (15 eyes) 3d group 61 70 years (27 eyes), 4th group 71-80 years (42 eyes), 5th group - over 81 years (17 eyes).
Preoperative examination revealed changes of morphometric characteristics of corneal endothelial cells with age: decreasing of cell density from 2614,5ḟ94,5 at age under 50 years to 2436,6ḟ93,2 at age over 81, percentage of hexagonal cells from 61,5% to 55,1%, the gradual increasing in the average endotheliocytes size, coefficient of variation of cell area. During the postoperative follow up in the age group over 81 years after surgical treatment percentage of hexagonal cells decreased to 39 %, coefficient of variation of cell area increased to 41%, endothelial cell loss amounted 49.2% in comparison with age group up to 50 years where postoperative percentage of hexagonal cells consist 54%, coefficient of variation of cell area 32%, endothelial cell loss amounted 7,9%. The phacoemulsification of cataract in age group above 81 years was accompanied by a maximum loss of endothelial cells 32,9 %, even with minimal cumulative energy consumed (CDE up to 10), in comparison with 54,7% endothelial cell loss with CDE above 20. At the same time, at a young age group there was a direct correlation of CDE and the percentage of endothelial cells loss which consist 4,9% in the less CDE (up to 10) and 55,9% with CDE above 20.
the risk for high endothelial cell loss should be considered when the phacoemulsification of high-density cataracts is performed at any age while at a young age there is a direct correlation of CDE and the percentage of endothelial cells loss.