Corneal Edema Monitoring After Cataract Phacoemulsification: Analysis Of The Corneal Epithelial Thickness Depending On The Endothelial Cell Density
Published 2025 - 43rd Congress of the ESCRS
Reference: PO904 | Type: Poster | DOI: 10.82333/g19j-wq33
Authors: Marta Cerdá-Ibáñez* 1 , Neus Burguera-Giménez 2 , Cristina Peris Martínez 3
1Anterior Segment Department,Fom,Valencia,Spain, 2Optics and Optometry,Fom,Valencia,Spain, 3Cornea Department,Fom,Valencia,Spain
Purpose
To assess the corneal epithelial thickness (CET) changes before and after uneventful cataract surgery taking into account the number of endothelial cell density (ECD).
Setting
Fundación de Oftalmología Médica (FOM)
Methods
This single-center and prospective study involved 51 eyes of 51 patients which were divided into two groups according to the ECD; low ECD (LECD): 21 eyes with less than 1500 cells/mm2 and high ECD (HECD): 30 eyes with more than 1500 cells/mm2. CET variations were studied in 9 epithelial sectors at first day, first week, first month and sixth months after phacoemulsification using an anterior swept-source OCT. The Wilcoxon-Mann-Whitney rank sum test was used to evaluate differences between groups, and a repeated measures analysis of covariance (ANCOVA) with preoperative ECD as a covariate was conducted in each out of 9 epithelial sectors.
Results
Preoperatively, patients with HECD presented 2.7 μm significant thicker CET than patients with LECD over the inferior sector (p=0.015). On day 1, significant higher epithelial thickening occurred in LECD group than HECD at inferior (3.3 μm vs. -1.1 μm, p= 0.001), nasal (3.7 μm vs. -0.2 μm, p<0.001), nasal-superior (3.3 μm vs. -0.7 μm, p<0.001) and nasal-inferior(3.7 μm vs. 0.9 μm, p<0.001) epithelial sector. On week 1, LECD group experimented non-significant greater epithelial thinning than HECD overall sectors. On month 1, significant epithelial thinning in LECD occurred (on average -1.9 μm, p= 0.024), meanwhile HECD returned to the baseline level (on average -0.4 μm, p> 0.05). On month 6, non-significant CET variations took place.
Conclusions
The immediate postoperative corneal oedema after phacoemulsification differently impacted in epithelial layer depending on endothelial cell count. The first day, greater transient epithelial oedema in patients with LECD occurred, following at one week and one month by a greater epithelial thinning. The epithelial remodeling varied according to ECD, being higher in LECD and over the inferior and nasal area, with no changes in the superior and temporal area where the main incision is located.