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Predictors of endothelial cell loss after phacoemulsification for primary angle-closure

Poster Details

First Author: C.Bonzano ITALY

Co Author(s):    C. Cutolo   C. Traverso                 

Abstract Details


To investigate clinical and anatomical factors associated with a reduction in endothelial cell count (ECC) after phacoemulsification (PE).


Clinica Oculistica, University of Genoa and Ospedale Policlinico San Martino, Genoa, Italy.


In this prospective study, endothelial cells were evaluated by noncontact specular microscopy, biometric parameters both by non-contact optical biometry and anterior segment optical coherence tomography, preoperatively and six months after surgery. Anterior segment biomicroscopy and gonioscopy were always performed. Percentage of ECC change and its relation to biometric parameters, including aqueous depth (AD) and angle parameters including Schwalbe line-angle opening distance (SL-AOD) and Schwalbe line-trabecular-iris space area (SL-TISA) were also evaluated.


37 eyes with primary angle closure glaucoma and 17 eyes with primary angle closure were included in the study. The mean (SD) patient age was 69.3 (10.7) years; thirty-three (61.1%) were women. Pseudoexfoliation (PEX) was observed in 5 cases (9.3%). The mean ECC [cells/mm2] changed from 2274 (463) preoperatively to 2011 (639) postoperatively with a mean reduction of -263 (95% CI - 410 to -115; P< 0.001). In the multivariate regression model after correction for age, no biometric factors were associated with ECC change (AD: p=0.9; SL-AOD: p=0.43; SL-TISA: p=0.38). PEX was associated with an increased ECC loss (r=-0.37; p=0.03).


PE in angle closure causes a significant ECC reduction. In our population of angle-closure patients, PEX was the only factor that significantly affects the ECC change. Preoperative endothelial cells evaluation should be performed in all patients submitted to PE for the treatment angle closure. The presence of PEX should be considered not only as a risk factor for intraoperative complications but also as a risk factor for postoperative corneal issues.

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