Corneal Endothelial Changes in Correlation with Corneal Thickness after Phacoemulsification among Diabetic Patients (original) (raw)
Advances in Ophthalmology & Visual System
We prospectively examined 23 eyes of each group of patients who were scheduled to have phacoemulsification surgery. Materials were collected from December 2016 till April 2017. Exclusion criteria were a history of previous ocular surgery or inflammation, abnormal findings by slit-lamp biomicroscopic examination, a small pupil diameter after a full dilation of less than 4.0 mm, and a preoperative endothelial cell density of less than 1500 cells/mm2. One surgeon performed all the surgeries. Specular microscopy was used on all eyes preoperatively, one week and one month postoperatively. Three photographs were taken per eye at each examination, and the mean of the measurements were calculated. The CCT (central corneal thickness), ECD (endothelial cell density), and CV (coefficient of variance) will be measured in all cases by automated analysis of the whole image. Complete medical history for type 2 diabetes based on medical history, blood glucose levels and HbA1c levels. Examination of visual acuity, subjective refraction, slit-lamp examination, IOP readings with applanation tonometry was done to all patients. Binocular indirect ophthalmoscopy was conducted for fundus examination. The density of the cataract was clinically graded by the same examiner on a scale of 1 to 6 using the Lens Opacities Classification system lll. IOL power and AC depth were recorded for all patients. A standardized stop and chop phacoemulsification technique was done with the phaco tip of 'white star Signature Pro®' Phaco-machine. Surgical techniques were conducted using retrobulbar anesthesia. Clear corneal incision was used with a 3.2 mm keratome. Sodium hyaluronate was injected to maintain the depth of the anterior chamber. Capsulorhexis completed using fine forceps. Hydro dissection was performed and the lens nucleus emulsified with Phaco machine using the stop and chop technique. The power used was 40-60%, a vacuum of 60-350 mmHg, and an aspiration flow rate of 25-30 ml/min. The bottle height raised to a maximum of 110 cm from a minimum of 90 cm during fragment removal. Figure 1 Nidek CEM5301.
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