Accelerated Corneal Endothelial Cell Loss after Phacoemulsification in Patients with Mildly Low Endothelial Cell Density
By evaluating preoperative endothelial cell density (ECD), ECD loss after phacoemulsification can be predicted. In this retrospective cross-sectional study, we compared outcomes of phacoemulsification with different levels of preoperative ECD. Three-hundred-and-fifty-three patients aged between 18 a...
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MDPI AG
2021-05-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/11/2270 |
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| author | Hung-Chi Chen Chen-Wei Huang Lung-Kun Yeh Fang-Chi Hsiao Yi-Jen Hsueh Yaa-Jyuhn James Meir Kuan-Jen Chen Chao-Min Cheng Wei-Chi Wu |
| author_facet | Hung-Chi Chen Chen-Wei Huang Lung-Kun Yeh Fang-Chi Hsiao Yi-Jen Hsueh Yaa-Jyuhn James Meir Kuan-Jen Chen Chao-Min Cheng Wei-Chi Wu |
| author_sort | Hung-Chi Chen |
| collection | DOAJ |
| description | By evaluating preoperative endothelial cell density (ECD), ECD loss after phacoemulsification can be predicted. In this retrospective cross-sectional study, we compared outcomes of phacoemulsification with different levels of preoperative ECD. Three-hundred-and-fifty-three patients aged between 18 and 90 years received phacoemulsification at Chang Gung Memorial Hospital. Age (<i>p</i> = 0.003), preoperative logMAR (<i>p</i> = 0.048), cataract grade (<i>p</i> = 0.005), preoperative ECD (<i>p</i> < 0.001), operation time (<i>p =</i> 0.043), phacoemulsification time (<i>p =</i> 0.001), and phacoemulsification energy (<i>p <</i> 0.001) were significantly associated with postoperative ECD change (%). Patients were divided into three groups according to preoperative ECD levels. Level of ECD, coefficient of variation (CV), cell hexagonality (HEX), central corneal thickness (CCT), visual acuity, underlying diseases, and complications were analyzed. With regard to groups, 29, 71, and 252 patients were respectively allocated into the markedly low (group A; ECD below 1000 cells/mm<sup>2</sup>), mildly low (group B; ECD between 1000 to 2000 cells/mm<sup>2</sup>), and normal (group C; ECD above 2000 cells/mm<sup>2</sup>) ECD level groups. The highest CV (40.8 ± 13.9%; <i>p <</i> 0.001) and lowest HEX (58.4 ± 14.6%; <i>p <</i> 0.001) were found in group A. Significant ECD loss was found in group B (28.9 ± 9.2%) as compared to group A (19.9 ± 5.4%) and C (15.0 ± 12.0%) (<i>p <</i> 0.001). No significant differences were found with regard to changes in CV (<i>p =</i> 0.941), HEX (<i>p =</i> 0.937), CCT (<i>p =</i> 0.346), and logMAR (<i>p =</i> 0.557) among the three groups. In conclusion, preoperative ECD level could be a novel predictive value for postoperative cell loss, which was the most prominent in mildly low ECD level group. Less phacoemulsification energy, earlier surgical intervention, or novel topical medications could be suggested for patients with an ECD range from 1000 to 2000 cells/mm<sup>2</sup>. |
| first_indexed | 2024-03-10T11:06:30Z |
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| language | English |
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| spelling | doaj.art-90b33880c47642ba8a67678f82dd06002023-11-21T21:07:44ZengMDPI AGJournal of Clinical Medicine2077-03832021-05-011011227010.3390/jcm10112270Accelerated Corneal Endothelial Cell Loss after Phacoemulsification in Patients with Mildly Low Endothelial Cell DensityHung-Chi Chen0Chen-Wei Huang1Lung-Kun Yeh2Fang-Chi Hsiao3Yi-Jen Hsueh4Yaa-Jyuhn James Meir5Kuan-Jen Chen6Chao-Min Cheng7Wei-Chi Wu8Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan 333423, TaiwanDepartment of Medicine, College of Medicine, Chang Gung University, Taoyuan 333323, TaiwanDepartment of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan 333423, TaiwanDepartment of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan 333423, TaiwanDepartment of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan 333423, TaiwanDepartment of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan 333323, TaiwanDepartment of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan 333423, TaiwanInstitute of Biomedical Engineering, National Tsing Hua University, Hsinchu 300044, TaiwanDepartment of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan 333423, TaiwanBy evaluating preoperative endothelial cell density (ECD), ECD loss after phacoemulsification can be predicted. In this retrospective cross-sectional study, we compared outcomes of phacoemulsification with different levels of preoperative ECD. Three-hundred-and-fifty-three patients aged between 18 and 90 years received phacoemulsification at Chang Gung Memorial Hospital. Age (<i>p</i> = 0.003), preoperative logMAR (<i>p</i> = 0.048), cataract grade (<i>p</i> = 0.005), preoperative ECD (<i>p</i> < 0.001), operation time (<i>p =</i> 0.043), phacoemulsification time (<i>p =</i> 0.001), and phacoemulsification energy (<i>p <</i> 0.001) were significantly associated with postoperative ECD change (%). Patients were divided into three groups according to preoperative ECD levels. Level of ECD, coefficient of variation (CV), cell hexagonality (HEX), central corneal thickness (CCT), visual acuity, underlying diseases, and complications were analyzed. With regard to groups, 29, 71, and 252 patients were respectively allocated into the markedly low (group A; ECD below 1000 cells/mm<sup>2</sup>), mildly low (group B; ECD between 1000 to 2000 cells/mm<sup>2</sup>), and normal (group C; ECD above 2000 cells/mm<sup>2</sup>) ECD level groups. The highest CV (40.8 ± 13.9%; <i>p <</i> 0.001) and lowest HEX (58.4 ± 14.6%; <i>p <</i> 0.001) were found in group A. Significant ECD loss was found in group B (28.9 ± 9.2%) as compared to group A (19.9 ± 5.4%) and C (15.0 ± 12.0%) (<i>p <</i> 0.001). No significant differences were found with regard to changes in CV (<i>p =</i> 0.941), HEX (<i>p =</i> 0.937), CCT (<i>p =</i> 0.346), and logMAR (<i>p =</i> 0.557) among the three groups. In conclusion, preoperative ECD level could be a novel predictive value for postoperative cell loss, which was the most prominent in mildly low ECD level group. Less phacoemulsification energy, earlier surgical intervention, or novel topical medications could be suggested for patients with an ECD range from 1000 to 2000 cells/mm<sup>2</sup>.https://www.mdpi.com/2077-0383/10/11/2270cataractphacoemulsificationcorneal endothelial cells |
| spellingShingle | Hung-Chi Chen Chen-Wei Huang Lung-Kun Yeh Fang-Chi Hsiao Yi-Jen Hsueh Yaa-Jyuhn James Meir Kuan-Jen Chen Chao-Min Cheng Wei-Chi Wu Accelerated Corneal Endothelial Cell Loss after Phacoemulsification in Patients with Mildly Low Endothelial Cell Density Journal of Clinical Medicine cataract phacoemulsification corneal endothelial cells |
| title | Accelerated Corneal Endothelial Cell Loss after Phacoemulsification in Patients with Mildly Low Endothelial Cell Density |
| title_full | Accelerated Corneal Endothelial Cell Loss after Phacoemulsification in Patients with Mildly Low Endothelial Cell Density |
| title_fullStr | Accelerated Corneal Endothelial Cell Loss after Phacoemulsification in Patients with Mildly Low Endothelial Cell Density |
| title_full_unstemmed | Accelerated Corneal Endothelial Cell Loss after Phacoemulsification in Patients with Mildly Low Endothelial Cell Density |
| title_short | Accelerated Corneal Endothelial Cell Loss after Phacoemulsification in Patients with Mildly Low Endothelial Cell Density |
| title_sort | accelerated corneal endothelial cell loss after phacoemulsification in patients with mildly low endothelial cell density |
| topic | cataract phacoemulsification corneal endothelial cells |
| url | https://www.mdpi.com/2077-0383/10/11/2270 |
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