Dados do Trabalho

Título

LONG-TIME FINDINGS AT THE CORNEAL ENDOTHELIUM IN EYES AFTER CATARACT SURGERY WITH CLEAR CORNEAL INCISION (CCI)

Fundamentação/Introdução

Introduction: The cataract surgery effects on the central Endothelial Mosaic (EM) are known, but they are not at the most proximal and distal areas of the incision, especially many years after.

Objetivos

Purpose: To evaluate corneal endothelial mosaic (EM) after phacoemulsification (PHACO) + Intraocular Lens (IOL) with CCI many years after the surgery at temporal CCI, central, and nasal peripheral areas.

Delineamento e Métodos

Methods: Cross-sectional study of the EM in a sample of 27 eyes after PHACO + IOL - SN60WF AcrySof® IQ Monofocal IOL (Alcon, Texas) with temporal CCI. The post-surgical time of the EM examination: From 2.1 to 14.1 years an average of 6.2±3.6 years. Inclusion criteria: The sampling process in each included EM examination by Specular Microscopy (SM) with a reliability degree of 95% and relative error (sample error) < 0.05 (5%) according to the Cells Analyzer (USA Patent) software (Technicall, Brazil). Each patient was submitted to Specular Microscopy (SM) at temporal CCI, central, and nasal peripheral areas, by the same expert examiner with BioOptics LSM 2500 Contact SM. Endothelial Cell Density (ECD), Cell Area (CA), polymegethism by Coefficient of Variation (CV), and pleomorphism by Percentage of Hexagonal Cells (HEX) were calculated by Bambi Plus 2500 software. Non-parametric Wilcoxon test, p< 0.05 was used to compare the variables described by mean and standard deviation.

Resultados

Results:
EM areas – Central x Incisional:
ECD: There is a significant decrease at the incision area (p<0.001) and near CCI was 48% smaller than the central area.
CA: There is a significant increase at the incision area (p<0.039) and near CCI was 101.5% higher than the central area.
CV: There are no significant changes at the incision area (p=0.981);
HEX: There are no significant changes in the incision area (p=0.904).
EM areas - Central x Nasal:
ECD: There is a significant increase at the nasal area (p=0.039) and at the most distant EM from CCI was 6.2% higher than the central area.
CA: There is a significant decrease in the nasal area (p<0.037) and 4.6% smaller than the central area.
CV: There is a significant increase in the nasal area (p<0.001);
HEX: There is a significant decrease in the nasal area (p=0.039).

Conclusões/Considerações Finais

Conclusions: There are EM cell changes many years after PHACO + IOL surgery at the clear cornea incision: ECD 48% smaller and CA 101.5% higher relative to the central area. The nasal peripheral area of the endothelial mosaic remains as expected.

Palavras-chave

Clear Corneal Incision, Corneal Endothelial Mosaic, Phacoemulsification, Intraocular Lens, Specular Microscopy.