Endothelial damage with cataract surgery techniques.
OBJECTIVE
To evaluate intraoperative endothelial damage after planned extracapsular cataract extraction (ECCE) with difference capsulotomy techniques and phacoemulsification.


METHODS
San Carlos University Hospital, Castroviejo Institute, Madrid, Spain.


METHODS
In this prospective, randomized study, 60 patients with senile cataract scheduled for cataract surgery were divided into three groups of 20 each: Group 1 had phacoemulsification; Group 2, planned ECCE with continuous curvilinear capsulorhexis; and Group 3, ECCE with letter-box capsulotomy. Preoperatively and 3 months postoperatively, endothelial cell density, percentage of hexagonality, and the cell size variation coefficient were determined by contact specular microscopy; endothelial permeability was examined by anterior segment fluorophotometry and central corneal thickness, by ultrasonic pachymetry. Results were analyzed using the two-tailed Student's t-test and analysis of variance.


RESULTS
In all three groups, endothelial permeability and cell loss increased significantly from the preoperative values, but there were not significant differences among the postoperative values. Mean cell loss was 11.8% in Group 1, 12.8% in Group 2, and 10.1% in Group 3. There were no differences between the preoperative and postoperative morphometric indexes. Postoperative pachymetric measurements were not significant.


CONCLUSIONS
Endothelial response was not statistically significantly different among the surgical techniques, although endothelial damage was lower in Group 3, which could indicate a protective effect of the anterior capsule during cataract extraction. Endothelial barrier function remained disturbed despite the apparent morphological stabilization.
Díaz-Valle
D
D
Departmet of Ophthalmology, Hospital General de Móstoles, Madrid, Spain.
Benítez del Castillo Sánchez
J M
JM
Castillo
A
A
Sayagués
O
O
Moriche
M
M
D000368:Aged; D019923:Capsulorhexis / Q000009:adverse effects* / Q000379:methods; D002452:Cell Count; D048429:Cell Size; D002470:Cell Survival; D004728:Endothelium, Corneal / Q000293:injuries* / Q000473:pathology; D005131:Eye Injuries / Q000209:etiology* / Q000473:pathology; D005260:Female; D015590:Fluorophotometry; D006801:Humans; D007431:Intraoperative Complications / Q000473:pathology; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D010539:Permeability; D018918:Phacoemulsification / Q000009:adverse effects* / Q000379:methods; D019904:Polymethyl Methacrylate; D011446:Prospective Studies
D019904:Polymethyl Methacrylate