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Adjunct oxygen therapy helps improve corneal edema after cataract surgery
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Transcorneal oxygen therapy as an adjunct to conventional therapy for severe corneal edema following cataract surgery preserved more endothelial cells and decreased corneal edema faster than conventional therapy alone or conventional therapy plus systemic oxygen, according to a study.
Forty-five patients with central corneal thickness of more than 1,000 µm at day 1 postoperatively were divided into three equal groups: a control group receiving conventional medical therapy, a group receiving medical therapy plus systemic normobaric 100% oxygen by facemask and a group receiving medical therapy and transcorneal 100% oxygen. Oxygen therapy continued for 3 weeks, and no oxygen-related complications were observed.
“Corneal edema with a rise in corneal thickness increases the distance for oxygen to reach the endothelium and thereby theoretically keeps the remaining endothelial cells under a relatively hypoxic state,” Farideh Sharifipour, MD, and colleagues at Imam Khomeini Hospital, Ahvaz, Iran, wrote, adding their postulate that “supplemental oxygen might improve endothelial pump function and restore corneal clarity.”
Endothelial cell count was best preserved in the transcorneal oxygen therapy group, with the smallest reduction of 25% when measured at 1 year, compared with a reduction of 37% in the control group and 32% in the normobaric oxygen group. Central corneal thickness improved in all groups, with a statistically significant greater improvement in the transcorneal oxygen group. At day 14, mean CCT was 91.1 µm less than in the control group (P < .001) and 36.7 µm less than in the normobaric oxygen group (P < .006).
Disclosure: The authors report no relevant financial disclosures.
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Sharifipour et al. J Cataract Refract Surg. 2015;doi:10.1016/j.jcrs.2014.10.033.
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