Although the technology and equipment of Phacoemulsification has been developing, and even some advanced technique such as micro-incision Phacoemulsifcation, cold ultrasonic surgcal system have been applied, the cases of corneal decompensation still occur sometimes. Once it happens, it is very difficult to deal with. So it is vital important to check and observe the corneal endothelium before and after the cataract surgery.
Objective this study is to observe the ralationship between the output energy of phacoemulsfication surgery and the corneal endothelial changes.
Methods We conducted a comparative analysis of the relevant parameters for treating 98 cases of cataract patients using AMO White Star Signature SMC dynamic real-time recording data before and after surgery. The number and morphology of the corneal endothelium of each patient was checked before surgery and post-operative one day, one week and one month .
Results On the first day after the surgery, in the corneal edema patients without corneal edema, the degree of corneal endothelial cell loss and the morphological damage had a positive correlation with the composite parameters of the output energy of phacoemulsification surgery, and a negative correlation with phacoemulsification full length of time and lens nucleus the level of positive correlation. Most of the morphological changes of endothelial damage can be restored relatively stable number of changes. The cases with corneal endothelial count below 1000 must be very cautious to decide surgery or not. According to cataract maturity, surgeon proficiency and surgical approach, a reasonable surgical style could be chosen. If the corneal endothelial count below 800 ECCE is a better choice. Based on pre-operative corneal technical screening, the results of this group of patients after surgery, no case occurs corneal endothelial decompensation.
Conclusion the corneal endothelial check is very important before phacoemulsification surgery, especially in senior patients and some suspected cases accompanied with other ocular diseases. The corneal endothelial morphological changes during the early stage of postoperative can recover, with the disapperance of corneal edema and inflammatory , however, it can’t return to the original number. Patients with the low corneal endothelial count (such as the critical value) after surgery, may occur corneal endothelial decompensation with the age increasing. |
