Sallam Moataz A, Zaky Khaled A
Ophthalmology Department, Faculty of Medicine - Suez Canal University Hospitals, 4.5 Kilo - Ring Road, Ismailia, 41522, Egypt.
Int Ophthalmol. 2025 Jan 29;45(1):45. doi: 10.1007/s10792-025-03415-7.
To assess the effect of anterior chamber depth on corneal endothelium using specular microscopy following uneventful phacoemulsification among cataract patients with different axial lengths.
The study was conducted in a quasi-experimental design including 300 eyes of 300 patients with grade three age-related nuclear cataract distributed equally based on their axial length into three equal groups. All eyes had grade three nuclear cataract. All patients underwent phacoemulsification using the same settings. They were assessed preoperatively and postoperatively at one week, one month and three months using specular microscopy. Outcome measures included endothelial cell density, axial length (AL), anterior chamber depth (ACD), ultrasound time (UST), cumulative dissipated energy (CDE) and intraoperative balanced salt solution (BSS) volume.
There were no significant differences (p > 0.05) between study groups regarding age, cataract density, UST, CDE and BSS volume. The endothelial cell density decreased significant (p < 0.001) postoperatively in all groups through the follow up period. However, the amount of change decreased as the end of follow up was approached. A significant negative correlation was found between amount of endothelial cell loss and ACD. However, no significant correlation existed between AL and ACD or ECL.
Endothelial cell density changes were significant following phacoemulsification. These changes were more in patients with shallow anterior chamber regardless of the axial length. Surgeons should adjust their surgical pattern considering our results.
通过镜面显微镜评估不同眼轴长度的白内障患者在白内障超声乳化术后前房深度对角膜内皮的影响。
本研究采用准实验设计,纳入300例年龄相关性核性白内障三级患者的300只眼,根据眼轴长度将其平均分为三组。所有患眼均为核性白内障三级。所有患者均采用相同参数进行白内障超声乳化术。术前及术后1周、1个月和3个月使用镜面显微镜对患者进行评估。观察指标包括内皮细胞密度、眼轴长度(AL)、前房深度(ACD)、超声乳化时间(UST)、累积耗散能量(CDE)及术中平衡盐溶液(BSS)用量。
研究组间在年龄、白内障密度、UST、CDE和BSS用量方面无显著差异(p>0.05)。随访期间,所有组内皮细胞密度术后均显著降低(p<0.001)。然而,随着随访接近尾声,变化量减小。内皮细胞损失量与ACD之间存在显著负相关。然而,AL与ACD或ECL之间无显著相关性。
白内障超声乳化术后内皮细胞密度变化显著。无论眼轴长度如何,前房浅的患者这些变化更大。外科医生应根据我们的结果调整手术方式。