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KMID : 0360220150560040521
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Journal of the Korean Ophthalmological Society
2015 Volume.56 No. 4 p.521 ~ p.531
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Protective Effect of Preoperative Intraocular Pressure Reduction on Corneal Endothelium in Cataract Surgery
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Ahn Yong-Sun
Cho Yang-Kyung
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Abstract
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Purpose: To evaluate whether intraocular pressure reduction by intravenous injection of mannitol before phacoemulsificationcataract surgery can have a protective effect on corneal endothelium.
Methods: Patients undergoing sequential bilateral cataract surgery were divided into 2 groups, 36 eyes with anterior chamber depth (ACD) ? 2.50 mm (group A) and 44 eyes with ACD ≥ 2.50 mm (group B). In each group, preoperative intravenous injection of mannitol was performed in 1 randomly selected eye of the patient. The specular microscopic examination including cell density (ECD), coefficient of variation (CV), hexagonality (HA) of corneal endothelium, and corneal thickness was performed on postoperative 1 day, 2 weeks, and 5 weeks. In each group, the parameters were compared between the eyes with mannitolization and the contralateral eyes without mannitolization.
Results: In group A, eyes with preoperative mannitolization showed significantly higher ECD at postoperative 1 day and 5 weeks and showed a significantly thinner cornea at postoperative 1 day than those without mannitolization (all p < 0.05). However, in group B, there was no significant difference of ECD, CV, HA, and corneal thickness between the eyes with and without mannitolization.
Conclusions: Preoperative intraocular pressure reduction by mannitolization before phacoemulsification can protect the corneal endothelial cells and recover the early postoperative period visual acuity in eyes with shallow anterior chamber.
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KEYWORD
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Corneal endothelium, Mannitol, Microphthalmos, Phacoemulsification, Shallow anterior chamber
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