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NR. 4(II)/2008
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Ocena gęstości
komórek śródbłonka po operacji usunięcia zaćmy metodą
fakoemulsyfikacji u pacjentów z dystrofią rogówkową Fuchsa w
porównaniu z pacjentami bez nieprawidłowości w obrębie
śródbłonka rogówki
Evaluation of Corneal Endothelial Cell Loss (ECL) after
Phacoemulsification Procedure in Patients with Corneal Fuchs
Dystrophy Compared to Patients without any Endothelial Pathology
Anna Kamińska, Justyna Izdebska,
Jacek P. Szaflik, Urszula Kołodziejska
Katedra i Klinika Okulistyki II Wydziału Lekarskiego
Warszawskiego Uniwersytetu Medycznego
Samodzielny Publiczny Kliniczny Szpital Okulistyczny w Warszawie
Kierownik: prof. dr hab. n. med. Jerzy Szaflik |
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| Summary: |
Purpose: To
evaluate corneal endothelial cell loss (ECL) after
phacoemulsification procedure in patients with corneal
Fuchs dystrophy compared to patients without any
endothelial pathology operated in Department of
Ophthalmology, Medical University of Warsaw, Poland.
Material and Methods: In this prospective study
40 patients (40 eyes) qualified to cataract surgery were
included to the study group. They were divided in to 2
groups of 20 patients. Group A – patients with cataract
and Fuchs corneal dystrophy with diagnosis confirmed
using in vivo confocal microscopy; Group B – patients
with cataract and without any endothelial pathology. In
vivo confocal microscopy of the central cornea using
CONFOSCAN 3 (Nidek Technology), was performed in all
cases preoperatively and postoperatively (5 weeks).
Endothelial cell density (ECD – cells/ square millimeter),
endothelial cell loss (ECL = preoperative ECD -postoperative
ECD), and proportional loss of cells [PLC = (ECL/
preoperative CD) x 100%], were calculated.
Results: Mean preoperative ECD in group A was
1057 (ranged 590-1207) and in group B 2180 (ranged
1530-2417). The loss rate of endothelial cell was 16.4%
in group A and 9.8% in group B. There were no
significant differences in BCVA between the two groups.
Localized corneal edema was observed in 4 eyes from
group A during first 3-4 days after surgery. However
permanent using of hyperosmotic drops weren’t necessary.
All corneas stay clear, without any signs of
decompensation.
Conclusions: Cataract surgery in the setting of
Fuchs dystrophy can be performed succesfully.
Preoperative evaluation of endothelium and its
protection during phacoemulsification procedure seams to
be as important as surgeon experience. However Fuchs
dystrophy is a progressive disorder so possibility of
keratoplasty in the future should be taken in to
consideration. In some cases cataract
phacoemulsification can be the first step of treatment
before deep endothelial lamellar keratoplasty. |
| Key words: |
Fuchs dystrophy, cataract
phacoemulsification, corneal endothelium. |
| Słowa kluczowe: |
dystrofia
śródbłonkowo-nabłonkowa Fuchsa, faksemulsyfikacja zaćmy,
śródbłonek rogówki. |
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