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Corneal endothelial morphologic assessment in pediatric cataract surgery with intraocular lens implantation: a comparison of preoperative and early postoperative specular microscopy.

Abstract：

PURPOSE:To observe longitudinal changes in the corneal endothelium after pediatric cataract surgery with intraocular lens implantation. DESIGN:Prospective, longitudinal study. METHODS:settings: Iladevi Cataract and IOL Research Centre, Ahmedabad, India. study population: This study included 100 pediatric eyes undergoing cataract surgery with intraocular lens implantation. Posterior capsule management was based on the status of the posterior capsule. Two-port anterior limbal vitrectomy was carried out after posterior capsule plaque peeling. observation procedures: Corneal endothelial morphologic features: endothelial cell density (cell/mm(2)), coefficient of variation, percentage of hexagonality, and central corneal thickness were assessed. main outcome measures: To evaluate whether there is a difference in endothelial cell morphologic features before surgery and 3 months after surgery and also whether pediatric cataract surgery with and without anterior vitrectomy has any impact on the endothelial cell morphologic features. RESULTS:A comparison of preoperative and postoperative specular microscopy is given here: endothelial cell density, 3225.1 ± 346.8 cells/mm(2) versus 3057.7 ± 330.1 cells/mm(2) (P < .001); coefficient of variation, 27.5 ± 10.6 versus 37.7 ± 16.3 (P < .001); percentage of hexagonality, 58.1 ± 15.3 versus 48.6 ± 13.4 (P < .001); and central corneal thickness, 529 ± 30 μm versus 527 ± 34 μm (P = .64). There was 5.1% decrease in mean endothelial cell loss at 3 months after surgery. No statistically significant difference was noted in the percentage decrease in mean endothelial cell density between eyes undergoing cataract surgery with intact posterior capsules, eyes undergoing manual posterior capsulorrhexis without anterior limbal vitrectomy, and eyes undergoing anterior limbal vitrectomy (P = .543). CONCLUSIONS:Endothelial cell loss with currently practiced techniques of pediatric cataract surgery is within acceptable limits by adhering to the principles of close chamber technique.

journal_name

Am J Ophthalmol

journal_title

American journal of ophthalmology

authors

Vasavada AR,Praveen MR,Vasavada VA,Shah SK,Vasavada V,Trivedi RH

doi

10.1016/j.ajo.2012.02.018

subject

Has Abstract

pub_date

2012-08-01 00:00:00

pages

259-265.e1

issue

eissn

0002-9394

issn

1879-1891

pii

S0002-9394(12)00122-5

journal_volume

154

pub_type

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Corneal endothelial morphologic assessment in pediatric cataract surgery with intraocular lens implantation: a comparison of preoperative and early postoperative specular microscopy.