Cataract surgery yields minimal loss of endothelial cell density, study shows

J Cataract Refract Surg. 2011;37(12):2130-2136.

Modern cataract surgery techniques yielded high safety profiles in a majority of eyes with low preoperative endothelial cell counts, a study found.

The retrospective study included 61 eyes of 52 patients with preoperative endothelial cell density (ECD) lower than 1,000 cells/mm². Mean preoperative ECD was 693 cells/mm².

Preoperative risk factors for ECD loss were Fuchs' dystrophy, laser iridotomy, keratoplasty, ocular trauma, trabeculectomy, corneal endotheliitis and other diagnoses.

Patients underwent hydrodissection and standard endocapsular phacoemulsification of the nucleus with the phaco chop technique. The Infiniti and Legacy phaco platforms (Alcon) were used to aspirate residual cortical material with balanced salt solution.

Mean postoperative follow-up was 14.6 months.

Study results showed statistically significant improvements in corrected distance visual acuity and IOP reduction (both P < .001). Mean postoperative ECD was 611 cells/mm². Mean ECD loss was about 80 cells/mm² (11.5%).

Leading risk factors for ECD loss or development of bullous keratopathy were axial length less than 23 mm, diabetes mellitus and posterior capsule rupture, according to the study.

"Although cataract surgery in eyes with a low preoperative ECD is a challenge, the rate of ECD loss in this study was almost the same as that in previous studies in eyes with a normal ECD," the study authors said.