Endothelial morphological and functional evaluation after cataract surgery.
OBJECTIVE
To assess endothelial barrier function, morphological appearance and corneal thickness three months after cataract surgery in order to evaluate intraoperative endothelial damage.


METHODS
Endothelial permeability was examined by fluorophotometry, and contact specular microscopy and corneal pachymetry measurements were made in 40 patients (40 eyes) with senile, non-complicated cataracts one month before and three months after cataract surgery. Twenty eyes underwent uneventful phacoemulsification (Group 1) and 20 uneventful extracapsular cataract extraction (ECCE) with continuous curvilinear capsulotomy (Group 2). Results were analyzed using the two-tailed Student's t test, analysis of variance, and multifactorial and regression analysis.


RESULTS
There was a significant postoperative increase in endothelial permeability in both groups (p < 0.001), but no real differences between the postoperative values (p = 0.07). Mean cell loss was 15.2% in ECCE and 18.3% in phacoemulsification (p = 0.4). There was a significant linear correlation between ultrasound time, cell loss and functional damage. Postoperative pachymetric measurements were not significant.


CONCLUSIONS
Endothelial response showed no differences between the surgical techniques. Endothelial barrier function remained disturbed in spite of the apparent morphological stabilization. Corneal pachymetry is not useful for assessing postoperative endothelial changes.
Díaz-Valle
D
D
Department of Ophthalmology, Castroviejo Institue, Complutense University, Madrid, Spain.
Benítez Del Castillo Sanchez
J M
JM
Toledano
N
N
Castillo
A
A
Pérez-Torregrosa
V
V
García-Sanchez
J
J
D000368:Aged; D002387:Cataract Extraction / Q000009:adverse effects / Q000379:methods; D002452:Cell Count; D002463:Cell Membrane Permeability; D003315:Cornea / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D004728:Endothelium, Corneal / Q000473:pathology* / Q000502:physiology*; D005260:Female; D015590:Fluorophotometry; D006801:Humans; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014463:Ultrasonography