title: Endothelial cell loss induced by phacoemulsification occurs through apoptosis.
abstract: BACKGROUND
  Cornea endothelial cells are nondividing cells containing pumping function which is crucial for cornea clarity and integrity. Endothelial cell loss occurs after cataract surgical procedures such as phacoemulsification. The authors hypothesize that endothelium damage occurs through apoptosis.
  
  
  METHODS
  Ultrasound was achieved by placing a phacoemulsification probe in the anterior chamber and delivering 0% or 50% of maximum power for 2.5 min. The corneal tissue was harvested immediately, and at 1 and 7 days after the operation. Corneal tissue was stained by hemotoxylin and eosin (H&E) and evaluated by light microscopy. Endothelium apoptosis was monitored using the terminal deoxynucleotidyl transferase-mediated dUTP-digoxigenin nick-end labeling (TUNEL) assay to detect DNA fragmentation.
  
  
  RESULTS
  In corneas which underwent phacoemulsification with 0% energy, no cell loss or apoptosis was identified immediately, 1 or 7 days after the operation. Likewise, in corneas exposed to 50% energy, no cell loss or apoptosis was detected immediately after phacoemulsification. However, minimal amount of cell loss but prominent apoptosis was detected with the TUNEL assay 1 day after the operation, whereas significant cell loss but no apoptosis was detected 7 days after the operation by H&E stain.
  
  
  CONCLUSIONS
  These results demonstrate that corneal endothelial cell loss induced by ultrasound damage occurs through apoptosis.
authors.affiliation: Department of Opthalmology, Chang Gung Memorial Hospital, 5, Fu-Shin Street, Kweishan, Taoyuan, 333, Taiwan, R.O.C.
authors.forename: L J
authors.initials: LJ
authors.lastname: Lai
authors.forename: Y F
authors.initials: YF
authors.lastname: Chen
authors.forename: S
authors.initials: S
authors.lastname: Wu
authors.forename: Y P
authors.initials: YP
authors.lastname: Tsao
authors.forename: R J
authors.initials: RJ
authors.lastname: Tsai
mesh_terms: D000818:Animals; D017209:Apoptosis; D053938:DNA Fragmentation; D004728:Endothelium, Corneal / Q000473:pathology*; D020287:In Situ Nick-End Labeling; D008297:Male; D018918:Phacoemulsification / Q000009:adverse effects*; D011817:Rabbits