Central Corneal Thickness And Endothelial Damage After Cataract Surgery

To study the relation between postoperative corneal edema and endothelial cell loss (ECL) after cataract surgery by microcoaxial phacoemulsification.

Department of ophthalmology, Mohamed Taher Maamouri hospital, Nabeul, Tunisia

This prospective observational study included eyes of patients with grade 1, 2, 3, or 4 nuclear cataract density according to the Lens Opacity Classification System (LOCS) III from Mars 2019 to May 2020. Central corneal thickness (CCT) and endothelial cell density (ECD) measurements were taken preoperatively, 1 day, 7 days and 1 month after surgery, using noncontact specular microscopy SPECULAR EM-4000 (TOMEY, Japan). A single-experienced surgeon performed all cataract procedures, using the Stellaris PC device (Bausch & Lomb, Bridgewater, NJ) in a microcoaxial mode with 2.2-mm incisions

74 eyes of 59 patients were operated. Mean age was 67,4 ± 7,2 years, with 41 women and 33 men. According to the LOCS III classification, the mean density of the nucleus was 2.45

Preoperatively, the mean CCT was 510 ± 19.8µm. Mean CCT increase was 1, 7 and 30 D after surgery was 34,9 µm (6,9%), 3,7 µm (0,7%), and 1,5 (0.3%) respectively. Mean ECL was 291 cells/mm² (11±5,1%)  at D7 and 327±134,5 cells/mm² (12,6±5,1%)at 1 month after surgery.

There was a positive correlation between the increase in CCT at D1 and total ECL at D30. A loss of endothelial cell more than 10% from baseline correlated to an increase of mean corneal thickness more than 10% and inversely. More over ECL and increase in CCT were proportional to cataract density.

Endothelial cell loss seems to be closely correlated with immediate postoperative edema

Postoperative corneal thickness measurement may therefore become a marker of endothelial damage after phacoemulsification.