Long Term Corneal Endothelium Changes Caused By Cataract Surgery
Published 2025 - 43rd Congress of the ESCRS
Reference: PO311 | Type: Free paper | DOI: 10.82333/p2dx-je54
Authors: Mireia García Bermúdez* 1 , Marco Antonio Pascual Santiago 1 , Patricia Robles Amor 1 , Javier García Bardera 1 , Laura Morales Fernández 1 , Jose María Martínez de la Casa 1 , Julián García Feijoo 1
1Ophthlamology ,Hospital Clínico San Carlos,Madrid,Spain
Purpose
The purpose of the study was to evaluate long-term corneal endothelial cell damage during cataract surgery expressed by EC density (ECD) loss, change in coefficient of variation (CV), and increase of central corneal thickness (CCT).
Setting
Prospective study.
Methods
300 eyes (n=180 having conventional Phaco surgery (CPS) vs. n=120 having FLACS) were enrolled. Patients were stratified by age group, cataract density and preoperative endothelial cell count. 73% of eye had normal ECD, 17% had endothelial dystrophy and 10% eyes had very dense cataract. The equivalent Phaco power (EqUSP), total ultrasound time (TUT) and cumulative dissipated energy (CDE) were recorded during cataract surgery and compared between FLACS and CPS group. The endothelial cell count (ECC, in cells/mm2), CV (%) and CCT (µm) were noted on specular microscopy at baseline, and at follow-up visits for at least 6 months postoperatively. Kruskal Wallis test (post hoc test Conover) was used for statistical analysis.
Results
EqUSP during surgery ranged from 8.7 to 20.8; TUT from 11 to 57 sec, and CDE from 4.04 to 21.3 and all values were signifcantly higher for dense cataract group. At 6 months of follow-up, there was a decline in the endothelial cell count. In helthy corneas EC loss was 362 ± 156 cells with CPS and 144±123 with FLACS, while in diseased corneas EC loss was 680± 170 with CPS vs 256± 187 in FLACS. The CV changed in healthy corneas from preop 38 to 45 in CPS vs. 34 to 38 in FLACS, and in case of endothelial disease from preop 46 to 66 in CPS vs 45 to 52 in FLACS. CCT changed from preop 537±26 to 567±15 in healthy corneas and from preop 560±25 to 595±42 in endothelial diseases.
Conclusions
Cataract surgery induced corneal endothelial cell damage is lower in FLACS compared with CPS at 6 postoperative months, which is clinically relevant in patients with ednothelial disease. EC damage was correlated to equivalent Phaco power (EqUSP), total ultrasound time (TUT) and cumulative dissipated energy (CDE) values during cataract surgery,