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[The relationship between the temperature increase caused by phacoemulsification and the damage to the corneal endothelium].

Abstract：

PURPOSE:Endothelial cell damage can be found after a phacoemulsification. The reason for this cell damage is not yet known. The temperature rise inside the anterior chamber during the emulsification of the lens is considered as a potential damage mechanism. The aim of this study was to investigate the relationship between the temperature increase and the cell damage. MATERIALS AND METHODS:This study was performed with 86 enucleated porcine eyes, which were divided into six groups A-F. Group A served as control group. Phacoemulsification was simulated in the groups B-E with different surgically relevant system settings. The temperature change was measured simultaneously with temperature sensors inside the anterior chamber. Inside the eyes of group F, the instruments were positioned and irrigation and aspiration were activated, but no ultrasound was applied. For all 86 corneas, the endothelial cell damage was quantified with a standardised evaluation protocol using scanning electron microscopy (SEM). A potential correlation was checked between the observed cell damage and the measured temperature rise. RESULTS:The highest temperature increase in group E with an obstructed aspiration line and an output power setting of 50 % was 17.77 °C. The temperature increase in group D with an output power setting of 100 % and unblocked fluid flow was significantly lower (p = 0.006). The highest temperature increase in group D was 8.89 °C. In contrast, the cells in group D were rated with a significantly lower score value than the cells in group E (p < 0.001). No significant correlation between the temperature rise and the cell damage could be obtained in due consideration of all measured data. However, an increase of the output power setting was connected with a non-linear increase of the cell loss. CONCLUSION:The temperature rise was not the main reason for the endothelial cell damage in the performed experiments. Therefore, there seems to be no causal relationship between the temperature increase inside the anterior chamber during a common phacoemulsification and the endothelial cell damage. Due to the strong dependence between the output power setting and the cell damage, the lowest output power setting should be used during surgery which ensures the emulsification of the nucleus.

journal_name

Klin Monbl Augenheilkd

journal_title

Klinische Monatsblatter fur Augenheilkunde

authors

Buschschlüter S,von Eicken J,Wilhelm U,Wilhelm F,Werschnik C,Schlüter R,Koch C,Höh H

doi

10.1055/s-0034-1382848

subject

Has Abstract

pub_date

2014-08-01 00:00:00

pages

822-9

issue

eissn

0023-2165

issn

1439-3999

journal_volume

231

pub_type

杂志文章

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[The relationship between the temperature increase caused by phacoemulsification and the damage to the corneal endothelium].