Galvis Virgilio, Prada Angelica Maria, Tello Alejandro, Parra Maria Margarita, Camacho Paul Anthony, Polit María Paz
Centro Oftalmológico Virgilio Galvis, Calle 158 20-95, Consultorio 301, Torre C, Cañaveral, Floridablanca, Santander, Colombia.
Universidad Autónoma de Bucaramanga (UNAB), Bucaramanga, Colombia.
Graefes Arch Clin Exp Ophthalmol. 2023 Nov;261(11):3215-3221. doi: 10.1007/s00417-023-06095-0. Epub 2023 May 25.
Intracameral antibiotics, such as moxifloxacin and cefuroxime, are safe to corneal endothelial cells and effective prophylaxis of endophthalmitis after cataract surgery. Corneal endothelial cells decrease in density after cataract surgery. Any substance used in the anterior chamber may affect corneal endothelial cells and lead to a greater decrease in density. This study wants to determine the percentage of endothelial cell loss after cataract extraction by phacoemulsification with off-label intracameral injection of moxifloxacin and dexamethasone (Vigadexa®).
An observational retrospective study was performed. The clinical records of patients undergoing cataract surgery by phacoemulsification plus intracameral injection of Vigadexa® were analyzed. Endothelial cell loss (ECL) was calculated using preoperative and postoperative endothelial cell density. The relation of endothelial cell loss with cataract grade using LOCS III classification, total surgery time, total ultrasound time, total longitudinal power time, total torsional amplitude time, total aspiration time, estimated fluid usage, and cumulative dissipated energy (CDE) was studied using univariate linear regression analysis and logistic regression analysis.
The median loss of corneal endothelial cells was 4.6%, interquartile range 0 to 10.4%. Nuclear color and CDE were associated with increased ECL. ECL>10% was associated with age and total ultrasound time in seconds.
The endothelial cell loss after the intracameral use of Vigadexa® at the end of cataract surgery was similar to the reported in other studies of cataract surgery without the use of intracameral prophylaxis for postoperative endophthalmitis (POE). This study confirmed the association of CDE and nuclear opalescence grade with postoperative corneal endothelial cell loss.
前房内注射抗生素，如莫西沙星和头孢呋辛，对角膜内皮细胞安全，且能有效预防白内障手术后的眼内炎。白内障手术后角膜内皮细胞密度会降低。前房内使用的任何物质都可能影响角膜内皮细胞，并导致密度进一步降低。本研究旨在确定在白内障超声乳化摘除术中使用超适应证的前房内注射莫西沙星和地塞米松（Vigadexa®）后内皮细胞损失的百分比。
进行了一项观察性回顾性研究。分析了接受白内障超声乳化联合前房内注射Vigadexa®手术患者的临床记录。使用术前和术后的内皮细胞密度计算内皮细胞损失（ECL）。采用单变量线性回归分析和逻辑回归分析研究内皮细胞损失与使用LOCS III分类法的白内障分级、总手术时间、总超声时间、总纵向能量时间、总扭转幅度时间、总抽吸时间、估计液体用量和累积消散能量（CDE）之间的关系。
角膜内皮细胞的中位损失为4.6%，四分位间距为0至10.4%。核颜色和CDE与ECL增加有关。ECL>10%与年龄和以秒为单位的总超声时间有关。
白内障手术结束时前房内使用Vigadexa®后的内皮细胞损失与其他未使用前房内预防性用药预防术后眼内炎（POE）的白内障手术研究报告的情况相似。本研究证实了CDE和核混浊分级与术后角膜内皮细胞损失之间的关联。
