Relationship between endothelial cell loss and microcoaxial phacoemulsification parameters in noncomplicated cataract surgery

• Published in: Clinical ophthalmology (Auckland, N.Z.) Vol. 6; no. default; pp. 503 - 510
• Main Authors: Mahdy, Mohamed Ae Soliman, Eid, Mohamed Z, Mohammed, Mahmoud Abdel-Badei, Hafez, Amr, Bhatia, Jagdish
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2012; Taylor & Francis Ltd; Dove Press; Dove Medical Press
• Subjects: Cataract; cataract surgery; Cataracts; Cells; cumulative dissipated energy; endothelial cells; Endothelium; Eye; Eye surgery; Hardness; Laboratories; Medical research; Medicine, Experimental; Ophthalmology; Original Research; Ozil; phacoemulsification; Pharmaceutical industry; Surgery; United States; Egypt; endothelial cells; cumulative dissipated energy; Ozil; cataract surgery; phacoemulsification
• ISSN: 1177-5483; 1177-5467; 1177-5483
• DOI: 10.2147/opth.s29865

To assess the relationship between postoperative endothelial cell loss and microcoaxial phaco parameters using Ozil IP (Alcon Laboratories, Inc, Fort Worth, TX) in noncomplicated cataract surgery. In this prospective observational study, 120 consecutive cases of cataract patients with different grades of nuclear hardness underwent microcoaxial phacoemulsification through a 2.2-mm clear corneal incision. An Alcon Infinity Vision System with Ozil IP (Alcon Laboratories) was used with an Ozil torsional handpiece and a Kelman-style 45° phacoemulsification tip. Patients underwent preoperative and postoperative central endothelial cell counts. The study included 120 cases of age-related cataract whose mean age (standard deviation [SD]) was 59.68 years (9.47). There was a highly statistically significant endothelial cell loss (P < 0.001). The endothelial cell loss ranged 11-1149 cells/mm(2) with a median (interquartile range) of 386 cells/mm(2) (184.5-686 cells/mm(2)). The percentage of postoperative ECLoss% ranged from 0.48% to 47.8% with a median (interquartile range) of 15.4% (7.2% to 26.8%). A significant positive correlation was found between the ECLoss% and different phaco parameters. The Spearman's rank-order correlation coefficient values, rho, (ρ) were as follows: CDE (ρ = 0.425), aspiration time (ρ = 0.176), and volume (ρ = 0.278). Also, ECLoss% was significantly correlated with the grade of nuclear opalescence (Kendall's tau τ = 0.42). Microcoaxial phacoemulsification was efficient in removing noncomplicated cataracts; however a statistically significant endothelial cell loss was noted, especially with increased nuclear hardness. This endothelial cell loss was mostly related to the increased cumulative dissipated energy (CDE), aspiration time, and volume of balanced salt solution used.