Khalid Muhammad, Ameen Sameer Shahid, Ayub Nauman, Mehboob Muhammad Asim
Dr. Muhammad Khalid, MBBS, Department of Ophthalmology, PNS SHIFA, Karachi, Pakistan.
Dr. Sameer Shahid Ameen, FCPS, Department of Ophthalmology, PNS SHIFA, Karachi, Pakistan.
Pak J Med Sci. 2019 Jan-Feb;35(1):200-204. doi: 10.12669/pjms.35.1.92.
To evaluate mean decrease in Corneal Endothelial cell Density (CED) after phacoemulsification in patients with different Anterior Chamber Depths (ACDs) and Axial Lengths (ALs).
This prospective stratified controlled study was conducted at PNS Shifa Hospital, Karachi. One hundred eyes of 90 patients, scheduled to undergo phacoemulsification surgery, were included. AL and ACD of each patient were calculated preoperatively using IOL Master. Cataracts were classified according toLens Opacities Classification System III (LOCS III) giving nuclear opalescence (NO) grades on slit lamp examination and only patients with grades NO2 and NO3 were included. Eyes were divided into two groups according to ACD and AL: Group-I: ACD 2.0mm - 3 mm and AL 22mm - 23.5mm; Group-II: ACD 3.1 mm -4.0 mm and AL 23.6mm - 25mm. CED measurements were done preoperatively and 2 month postoperatively using specular microscopy. The difference in CED change (Endothelial Cell Loss) between the two groups after surgery was analyzed using SPSS, v 22; IBM Corporation, Armonk, NY.
Differences in gender, laterality, age and preoperative CED between two groups were not significant. Difference in postoperative CED was also not significant, however difference in mean change and mean frequency change in CED between two groups was found to be statistically significant.
ACD and AL affect the CED during phacoemulsification and Intraocular Lens(IOL) implantation and can be considered as risk factors of peroperative endothelial cell loss.
评估不同前房深度(ACD)和眼轴长度(AL)的患者在白内障超声乳化术后角膜内皮细胞密度(CED)的平均降低情况。
本前瞻性分层对照研究在卡拉奇的PNS Shifa医院进行。纳入了90例计划接受超声乳化手术患者的100只眼。术前使用IOL Master计算每位患者的AL和ACD。根据晶状体混浊分类系统III(LOCS III)对白内障进行分类,在裂隙灯检查时给出核混浊(NO)等级,仅纳入NO2和NO3级的患者。根据ACD和AL将眼睛分为两组:第一组:ACD 2.0mm - 3mm且AL 22mm - 23.5mm;第二组:ACD 3.1mm - 4.0mm且AL 23.6mm - 25mm。术前和术后2个月使用镜面显微镜进行CED测量。使用SPSS v 22(IBM公司,纽约州阿蒙克)分析两组术后CED变化(内皮细胞损失)的差异。
两组之间在性别、眼别、年龄和术前CED方面的差异无统计学意义。术后CED的差异也无统计学意义,然而,两组之间CED的平均变化和平均频率变化的差异具有统计学意义。
ACD和AL在白内障超声乳化及人工晶状体(IOL)植入过程中会影响CED,可被视为术中内皮细胞损失的危险因素。