J Korean Ophthalmol Soc > Volume 58(11); 2017 > Article
Journal of the Korean Ophthalmological Society 2017;58(11):1215-1224.
DOI: https://doi.org/10.3341/jkos.2017.58.11.1215    Published online November 15, 2017.
Change of Corneal Epithelial and Stromal Thickness after Cataract Surgery through Scleral Tunnel Incision.
Bong Jun Kim, Jong Hyuck Lee, Sun Woong Kim
Department of Ophthalmology, Yonsei University Wonju College of Medicine, Wonju, Korea. eyedockim@yonsei.ac.kr
공막터널을 통한 백내장수술 후의 각막 상피 및 기질의 두께 변화
김봉준⋅이종혁⋅김선웅
연세대학교 원주의과대학 안과학교실
Correspondence:  Sun Woong Kim,
Email: eyedockim@yonsei.ac.kr
Received: 25 May 2017   • Revised: 7 September 2017   • Accepted: 17 October 2017
Abstract
PURPOSE
To compare preoperative and postoperative thickness and to investigate the difference in the thickness change of corneal epithelium and stroma after cataract surgery through scleral tunnel incision. METHODS: Forty eyes of forty patients who were 40 years old or older and underwent small-incision superior scleral tunnel cataract surgery with phacoemulsification were included. Using the RTVue instrument (Optovue Inc., Fremont, CA, USA), corneal epithelial (ET) and stromal thicknesses (ST) of all subjects were measured preoperatively and at 3 days, 1 week, and 1 month postoperatively. Thicknesses were classified into 3 zones according to the distance from the vertex: central zone (within 2 mm), paracentral zone (2-5 mm diameter) and midperipheral zone (5-6 mm diameter). RESULTS: Mean central ST was 486.68 ± 25.15 µm, 535.16 ± 48.13 µm, 515.98 ± 44.07 µm, and 502.28 ± 34.87 µm preoperatively, and at 3 days, 1 week, and 1 month postoperatively, respectively (p < 0.001 for all). ST showed significant thickening in all three zones from 3 days to 1 month postoperatively (p < 0.001 for all). Mean central, paracentral, and midperipheral ET was 52.13 ± 3.41 µm, 50.42 ± 2.97 µm, 49.12 ± 3.05 µm at preoperatively and 51.03 ± 3.63 µm, 48.96 ± 3.62 µm, 47.67 ± 3.81 µm at 1 month postoperatively, respectively (p = 0.061, 0.006, 0.001, respectively), while there were no signficant changes in all three zones at 3 and 7 days postoperatively. Changes in ET and ST were prominent at the superotemporal incision site. CONCLUSIONS: After scleral tunnel cataract surgery, corneal edema was observed in the stroma immediately after surgery. There was no significant change at early times after surgery in the epithelium, and there was a decrease in the peripheral cornea at 1 month postoperatively. The change in ET was considered a compensatory change due to stromal edema and appeared between 1 week to 1 month postoperatively.
Key Words: Cataract surgery;Corneal epithelium;Corneal remodeling;Corneal stroma;Corneal thickness


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