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      초음파수정체유화술에서 핵경화도에 따라 누적분사에너지가 각막내피세포에 미치는 영향 = Effects of Cumulative Dissipated Energy on Corneal Endothelial Cells in Phacoemulsification Based on Nucleus Sclerosis

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      https://www.riss.kr/link?id=A109368063

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      Purpose: To investigate changes in corneal endothelial cell (CEC) by cumulative dissipated energy (CDE) during phacoemulsification.
      Methods: Based on the degree of nucleus sclerosis (NS), changes in CECs were compared preoperatively and at 1 and 3 months postoperatively in 67 eyes that underwent phacoemulsification.
      Results: The mean CDE used during surgery was 4.30 ± 2.31. A comparison of the surgical measurements before and 1 month after surgery revealed significant differences in the cell density (CD) and coefficient of variation (CV) (p < 0.001, 0.011, respectively). The CD showed significant differences among NS grades 2–6 (p < 0.001). The CDE increased significantly with higher NS grades (r = 0.809, p < 0.001). Within the same NS grade, there was a positive correlation between higher CDE and greater CEC loss (r = 0.559, p = 0.001). CD changes were significantly associated with increasing CDE (r = 0.612, p < 0.001). The CD loss also increased significantly from NS2 to NS6 (p < 0.001). At 3 months postoperatively, surgical measurements revealed a significant decrease in CD with increasing NS grade (p = 0.010).
      Conclusions: CDE increased with higher NS grades and there was a positive correlation between CDE and CEC loss. Therefore, surgeons should plan surgical techniques preoperatively to minimize CDE as NS increases. Additionally, it is important to assess CEC damage postoperatively based on surgical measurements in patients with high intraoperative CDE.
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      Purpose: To investigate changes in corneal endothelial cell (CEC) by cumulative dissipated energy (CDE) during phacoemulsification. Methods: Based on the degree of nucleus sclerosis (NS), changes in CECs were compared preoperatively and at 1 and 3 mon...

      Purpose: To investigate changes in corneal endothelial cell (CEC) by cumulative dissipated energy (CDE) during phacoemulsification.
      Methods: Based on the degree of nucleus sclerosis (NS), changes in CECs were compared preoperatively and at 1 and 3 months postoperatively in 67 eyes that underwent phacoemulsification.
      Results: The mean CDE used during surgery was 4.30 ± 2.31. A comparison of the surgical measurements before and 1 month after surgery revealed significant differences in the cell density (CD) and coefficient of variation (CV) (p < 0.001, 0.011, respectively). The CD showed significant differences among NS grades 2–6 (p < 0.001). The CDE increased significantly with higher NS grades (r = 0.809, p < 0.001). Within the same NS grade, there was a positive correlation between higher CDE and greater CEC loss (r = 0.559, p = 0.001). CD changes were significantly associated with increasing CDE (r = 0.612, p < 0.001). The CD loss also increased significantly from NS2 to NS6 (p < 0.001). At 3 months postoperatively, surgical measurements revealed a significant decrease in CD with increasing NS grade (p = 0.010).
      Conclusions: CDE increased with higher NS grades and there was a positive correlation between CDE and CEC loss. Therefore, surgeons should plan surgical techniques preoperatively to minimize CDE as NS increases. Additionally, it is important to assess CEC damage postoperatively based on surgical measurements in patients with high intraoperative CDE.

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      참고문헌 (Reference)

      1 Abell RG, "Toward zero effective phacoemulsification time using femtosecond laser pretreatment" 120 : 942-948, 2013

      2 Sugar J, "The effect of phacoemulsification on corneal endothelial cell density" 96 : 446-448, 1978

      3 Bourne WM, "Specular microscopy of human corneal endothelium in vivo" 81 : 319-323, 1976

      4 O'Brien PD, "Risk factors for endothelial cell loss after phacoemulsification surgery by a junior resident" 30 : 839-843, 2004

      5 Hayashi K, "Risk factors for corneal endothelial injury during phacoemulsification" 22 : 1079-1084, 1996

      6 McCarey BE, "Review of corneal endothelial specular microscopy for FDA clinical trials of refractive procedures, surgical devices, and new intraocular drugs and solutions" 27 : 1-16, 2008

      7 Maalej A, "Ozil® versus conventional ultrasound phacoemulsification : a randomized comparative study" 35 : 565-568, 2015

      8 Choi JY, "Long-term(≥10 years)results of corneal endothelial cell loss after cataract surgery" 54 : 438-444, 2019

      9 양재니 ; 이진기, "Long-term endothelial cell changes after anglesupported anterior chamber lens implantation in phakic eyes" 53 : 208-214, 2012

      10 Bui AD, "Factors impacting cumulative dissipated energy levels and postoperative visual acuity outcome in cataract surgery" 21 : 439-, 2021

      1 Abell RG, "Toward zero effective phacoemulsification time using femtosecond laser pretreatment" 120 : 942-948, 2013

      2 Sugar J, "The effect of phacoemulsification on corneal endothelial cell density" 96 : 446-448, 1978

      3 Bourne WM, "Specular microscopy of human corneal endothelium in vivo" 81 : 319-323, 1976

      4 O'Brien PD, "Risk factors for endothelial cell loss after phacoemulsification surgery by a junior resident" 30 : 839-843, 2004

      5 Hayashi K, "Risk factors for corneal endothelial injury during phacoemulsification" 22 : 1079-1084, 1996

      6 McCarey BE, "Review of corneal endothelial specular microscopy for FDA clinical trials of refractive procedures, surgical devices, and new intraocular drugs and solutions" 27 : 1-16, 2008

      7 Maalej A, "Ozil® versus conventional ultrasound phacoemulsification : a randomized comparative study" 35 : 565-568, 2015

      8 Choi JY, "Long-term(≥10 years)results of corneal endothelial cell loss after cataract surgery" 54 : 438-444, 2019

      9 양재니 ; 이진기, "Long-term endothelial cell changes after anglesupported anterior chamber lens implantation in phakic eyes" 53 : 208-214, 2012

      10 Bui AD, "Factors impacting cumulative dissipated energy levels and postoperative visual acuity outcome in cataract surgery" 21 : 439-, 2021

      11 Kreisler KR, "Endothelial cell loss following"modern"phacoemulsification by a senior resident" 23 : 158-160, 1992

      12 Colvard DM, "Endothelial cell loss following phacoemulsification in the pupillary plane" 7 : 334-336, 1981

      13 Bourne WM, "Endothelial cell loss during penetrating keratoplasty" 85 : 760-766, 1978

      14 Vargas LG, "Endothelial cell integrity after phacoemulsification with 2 different handpieces" 30 : 478-482, 2004

      15 Amon M, "Endothelial cell density and corneal pachometry after no-stitch, small-incision cataract surgery" 81 : 301-307, 1992

      16 Pirazzoli G, "Effects of phacoemulsification time on the corneal endothelium using phacofracture and phaco chop techniques" 22 : 967-969, 1996

      17 Khalid M, "Effects of anterior chamber depth and axial length on corneal endothelial cell density after phacoemulsification" 35 : 200-204, 2019

      18 Bourne RR, "Effect of cataract surgery on the corneal endothelium : modern phacoemulsification compared with extracapsular cataract surgery" 111 : 679-685, 2004

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