Briceno-Lopez Celeste, Burguera-Giménez Neus, García-Domene M Carmen, Díez-Ajenjo M Amparo, Peris-Martínez Cristina, Luque M José
Department of Optics and Optometry and Vision Sciences, Faculty of Physics, Universitat de València, Dr. Moliner 50, E-46100 Burjassot, Spain.
Cátedra Alcon-FOM-UVEG, Universitat de València, Dr. Moliner 50, E-46100 Burjassot, Spain.
J Clin Med. 2023 Oct 25;12(21):6751. doi: 10.3390/jcm12216751.
This systematic review investigates the prevalence and underlying causes of corneal edema following cataract surgery employing manual phacoemulsification. A comprehensive search encompassing databases such as PubMed, Embase, ProQuest, Cochrane Library, and Scopus was conducted, focusing on variables encompassing cataract surgery and corneal edema. Two independent reviewers systematically extracted pertinent data from 103 articles, consisting of 62 theoretical studies and 41 clinical trials. These studies delved into various aspects related to corneal edema after cataract surgery, including endothelial cell loss, pachymetry measurements, visual performance, surgical techniques, supplies, medications, and assessments of endothelial and epithelial barriers. This review, encompassing an extensive analysis of 3060 records, revealed significant correlations between corneal edema and endothelial cell loss during phacoemulsification surgery. Factors such as patient age, cataract grade, and mechanical stress were identified as contributors to endothelial cell loss. Furthermore, pachymetry and optical coherence tomography emerged as valuable diagnostic tools for assessing corneal edema. In conclusion, this systematic review underscores the link between corneal edema and endothelial cell loss in manual phacoemulsification cataract surgery. It highlights the relevance of factors like patient demographics and diagnostic modalities. However, further research is essential to unravel the complexities of refractive changes and the underlying mechanisms.
本系统评价研究了采用手动超声乳化白内障手术后角膜水肿的患病率及潜在原因。进行了全面检索,涵盖了如PubMed、Embase、ProQuest、Cochrane图书馆和Scopus等数据库,重点关注包括白内障手术和角膜水肿在内的变量。两名独立评审员系统地从103篇文章中提取了相关数据,其中包括62项理论研究和41项临床试验。这些研究深入探讨了白内障手术后与角膜水肿相关的各个方面,包括内皮细胞损失、角膜厚度测量、视觉性能、手术技术、耗材、药物以及内皮和上皮屏障评估。本综述对3060条记录进行了广泛分析,揭示了超声乳化手术过程中角膜水肿与内皮细胞损失之间的显著相关性。患者年龄、白内障分级和机械应力等因素被确定为内皮细胞损失的促成因素。此外,角膜厚度测量和光学相干断层扫描成为评估角膜水肿的有价值诊断工具。总之,本系统评价强调了手动超声乳化白内障手术中角膜水肿与内皮细胞损失之间的联系。它突出了患者人口统计学和诊断方式等因素的相关性。然而,进一步的研究对于阐明屈光变化的复杂性及其潜在机制至关重要。