ESCRS - PO0917 - Findings And Follow-Up Of Corneal Endothelial Changes By Confocal Microscopy And Specular Microscopy In Patients With Fuchs Uveitic Syndrome Undergoing Phacoemulsification Surgery With Intraocular Lens Implantation.

Findings And Follow-Up Of Corneal Endothelial Changes By Confocal Microscopy And Specular Microscopy In Patients With Fuchs Uveitic Syndrome Undergoing Phacoemulsification Surgery With Intraocular Lens Implantation.

Published 2023 - 41st Congress of the ESCRS

Reference: PO0917 | Type: Free paper | DOI: 10.82333/yjc3-1408

Authors: Miguel Ibanez-Ezparza* 1 , Roberto Gonzalez-Salinas 1 , Emmanuel Cabrera 2 , Miguel Castro-Monreal 1 , Patricia Navarro-López 3

1Anterior Segment Department,Association to Prevent Blindness in Mexico, IAP,Mexico City,Mexico, 2Cornea and Refractive Surgery Department,Association to Prevent Blindness in Mexico, IAP,Mexico City,Mexico, 3Ocular Inflammatory Diseases Department,Association to Prevent Blindness in Mexico, IAP,Mexico City,Mexico

Purpose

To evaluate corneal endothelial changes using confocal microscopy and specular microscopy in patients with Fuchs uveitic syndrome (FUS) undergoing phacoemulsification surgery with intraocular lens implantation. We aimed to compare the endothelial cell loss and morphological changes after surgery.

Setting

Ocular Inflammatory Diseases Clinic, Luis Sanchez Bulnes Hospital, Association to Prevent Blindness in Mexico, IAP, Mexico City, Mexico.

Methods

We recruited fourteen patients with unilateral FUS who had developed a cataract and underwent phacoemulsification surgery and intraocular lens implant. Confocal and specular microscopies were taken before surgery. Surgery was performed in the FUS eye by a single surgeon while using the same parameters and phacoemulsification equipment for all patients. An intraocular lens was implanted in all cases. Subsequently, clinical follow-up was given at one week, one month, 6 months, and 12 months after surgery. Both specular microscopy and confocal microscopy were performed at 6 months after surgery for the eye with FUS and compared with baseline images.

Results

All patients underwent uncomplicated phacoemulsification surgery with intraocular lens implantation in the eye with FUS. There was no significant change in Endothelial Cell Density (ECD) from 2267 (± 564.3) cells/mm2 preoperatively to 2199 (± 528.7) cells/mm2 postoperatively (p = 0.755). Confocal microscopy revealed increased endothelial heterogeneity and reflectivity in the eye with FUS. The only variable that reached statistical significance was the Keratic Precipitates Density (KPD) seen in confocal microscopy, which decreased from a median of 1413 (± 2809.7) KPs/mm2 preoperatively to a median of 685.5 (1527.9) KPs/mm2 postoperatively (p = 0.036).

Conclusions

Phacoemulsification surgery with intraocular lens implantation in patients with FUS causes slight endothelial cell loss and morphological changes that can be detected by confocal microscopy and specular microscopy. We did find a reduction of KPD after surgery in confocal microscopy that may have implications for the long-term corneal health of these patients. We recommend careful monitoring of the corneal endothelium in patients with FUS who undergo cataract surgery.