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Methods of corneal protection with particular reference to endothelial cells during phacoemulsification

Poster Details

First Author: J.Deren POLAND

Co Author(s):    K. Sowa   E. Mrukwa-Kominek   M. Prost              

Abstract Details

Purpose:

Phacoemulsification is a commonly used method of cataract surgery, performed on an increasing number of people. As the population ages, the need for cataract surgery increases. A growing interest in the treatment is also due to raising awareness of a need to monitor the quality of life and to keep it on the highest level. As phacoemulsification is not neutral for cornea condition, the aim of this article is to systematize factors that have negative influence to cornea during phacoemulsification and the possibilities of protecting it.

Setting:

1 Department of Ophthalmology for Adults, Ophthalmology Clinic, Katowice Division, Medical University of Silesia 2 Department of Ophthalmology , Professor Gibinski University Clinical Center, Medical University of Silesia, Katowice, Poland 3. Military Institute of aviation Medicine

Methods:

The medical literature related to the topic was analized. Tags used to search articles in a web search engine PubMed were: phacoemulsification influence endothelium/cornea, cataract surgery protection endothelium/cornea. Only articles published between 2010 and 2017 were chosen. Articles in number of 81 were found, from which 28 was excluded: 8 did not fulfill the language criteria (only 3 languages, English, Polish and Spanish, were taken into consideration), in 10 cases the topic was irrelevant, 10 were not related to studies on human subjects.

Results:

Most commonly reported complication of cataract surgery was endothelial cell loss. Ultrasounds have been identified as factor that damages the corneal endothelium during phacoemulsification in majority of the articles, while cataract hardness, intra ocular pressure and temperature �â�€�“ decidedly less. In all articles the range in decrease in endothelial cell density fluctuates around 1-25,8% (depending on operating technique and time point of postoperative examination). Predominantly the use of ophthalmic viscosurgical devices and surgical methods were examined. Cell density and central corneal thickness were measured most often to evaluate corneal epithelium damage.

Conclusions:

Factors such as ultrasounds, temperature and type of incision have an influence on corneal condition: its structure and the extent of damage after surgery. Patients with corneal dysfunctions deserve special attention, because any surgical intervention may cause irreversible lesions, such as endothelial cell loss with following corneal decompensation. Before performing phacoemulsification, patient�â�€�™s medical condition should be evaluated to choose the best method of corneal protection. Development of new surgical techniques and improvement of medical equipment minimalize surgical complications.

Financial Disclosure:

NONE

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