Fakoemülsifikasyon cerrahisinde ön kamara derinliğinin endotel hücre sayısı ve postoperatif korneal ödem üzerine etkisi

Amaç: Fakoemülsifikasyon cerrahisi yapılan olgularda, ön kamara derinliğinin korneal endotel hücre kaybına ve postoperatif korneal ödem gelişimine etkisinin incelenmesi. Gereç ve yöntem: Senil katarakt tanısı alıp fakoemülsifikasyon cerrahisi uygulanmış 35 vakanın ultrasonik biyometri ile ölçülen preoperatif ön kamara derinliğinin endotel hücre kaybı ve postoperatif santral kornea kalınlığına etkisi, speküler mikroskopi verileri kullanılarak incelendi. Bulgular: Olguların yaş ortalaması 64.8 ± 10.7 yıl (42 - 84 yaş) idi. Preoperatif ön kamara derinliği 3.37 ± 0.51 mm (1.61-4.33 mm), hücre yoğunluğu 2345 ± 341 hücre/mm² (1600-2915 hücre/mm²) santral kornea kalınlığı (SKK) 535.9 ± 32.3 μ (457-588 μ) idi. Postoperatif endotel hücre yoğunluğu 1. haftada 1876 ± 443 hücre/mm², 1. ayda 1882 ± 457 hücre/mm², 3. ayda 1920 ± 456 hücre/mm² olarak saptandı. Preoperatif değer ile kıyaslandığında; 1. hafta, 1. ay ve 3. aydaki hücre yoğunluğu azalmalarının anlamlı olduğu bulundu (p

The effect of anterior chamber depth on endothelial cell count and postoperative corneal edema in phacoemulsification surgery

Objectives: To investigate the effect of anterior chamber depth on corneal endothelial cell loss and development of postoperative corneal edema in patients undergoing phacoemulsification surgery. Materials and methods: The effect of preoperative anterior chamber depth was evaluated by ultrasound biometry of 35 eyes with senile cataract and treated with phacoemulsification on intraoperative endothelial cell loss and at postoperative central corneal thicknesses by specular microscopy. Results: The mean age was 64.8 ± 10.7 years (range 42-84). Preoperative anterior chamber depth, cell density and central corneal thickness were 3.37 ± 0.51 mm (1.61-4.33 mm), 2345 ± 341 cell/mm² (1600-2915 cell/mm²) and 536 ± 32 μ (457-588 μ) respectively. Postoperative endothelial cell densities were detected 1876 ± 443 cell/mm², 1882 ± 457 cell/mm² and 1920 ± 456 cell/mm² at first week, first month and at third month respectively. Compared to preoperative values, decreases of endothelial cell densities at postoperative first week, first month and third month were found to be significant (p<0.001). There was a significant and reverse correlation between anterior chamber depth and endothelial cell loss at first week (p=0.025). Postoperative central corneal thickness was 568.74 ± 43.46 μ, 539.60 ± 37.51 μ and 533.46 ± 34.78 μ at first week, first month and at third month respectively, and this changes were statistically significant (p<0.001). No significant association was found between anterior chamber depth and the increase of central corneal thickness at first week (p>0.05). Conclusion: Phacoemulsification surgery leaded to more endothelial cell loss than expected in patients with shallow anterior chamber. Anterior chamber depth should preoperatively be evaluated especially in the elderly and/or patients with endothelial dystrophy.

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