Journal of the Korean Ophthalmological Society 1998;39(10):2272-2279.
Published online October 1, 1998.
The Evaluation of the Endothelial Cells after Cataract Extraction and IOL Insertion in Patients with Corneal Guttata.
Kyoo Il Lee, Man Soo Kim
Department of Ophthalmology, Kangnam St. Mary`s Hospital Catholic University, Medical College, Seoul, Korea.
Guttata 환자에서 백내장 적출 및 인공수정체 삽입이 각막 내피세포에 미치는 영향
이규일(Kyoo Il Lee),김만수(Man Soo Kim)
Abstract
When the corneal endothelium is injured by intraocular surgery, corneal edema occurs above the threshold level. Preoperative examination of corneal endothelium is valuable in prediction the degree of transparency of the cornea. We conducted this study to elucidate what factors affect corneal endothelial cells in performing the cataract extraction and IOL insertion and what is necessary to minimize the corneal endothelial damage. We performed pacoemulsification and IOL insertion in guttata patients, and preoperative and postoperative endothelial examination was done by using specuar microscope and pachymeter. Although the mean of endothelial cell density was diminished from 1498.7cells/mm2 to 1301cells/mm2 after operation. visible edema was not detected by slit lamp examination and visual acuity was improved from 0.15 to 0.48. The older the patient`s age, the longer the time of phaceemulsification; as the ages of the patients are increased, postoperative corneal thicknesses were increased and postoperative endothelial cell densities were decreased. The endothelial cells were relatively well preserved after cataract operation in patients of preoperative diminished endothelial cells. We suggest that when performing the cataract operation in patients of decreased endothelial function, one must use appropriate large amount of viscoelastic substances, and minimize phacoemulsification power and time in as short operation time as possible by accurate surgical technique. We also believe that periodic postoperative endothelial examination is necessary in patients with decreased endothelial function.
Key Words: Corneal endothelium;Pachymeter;Specular microscope


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