Morfologia i morfometria śródbłonka rogówki po operacji zaćmy – przegląd piśmiennictwa
Morphology and Morphometry of the Corneal Endothelium after Cataract Surgery – Literature Review
Agnieszka Grądek-Motyl1, Ewa Mrukwa-Kominek2
1 Okulus Plus w Bielsku-Białej
Kierownik medyczny: dr n. med. Iwona Filipecka
2 Klinika Okulistyki Katedry Okulistyki Śląskiego Uniwersytetu Medycznego w Katowicach
Kierownik: prof. dr hab. n. med. Wanda Romaniuk
Summary: Phacoemulsification is the worldwide gold standard for cataract surgery. Modern phacoemulsification techniques have enabled surgeons to reduce ultrasonic energy and phaco time. Interrupted phaco modes, improved pump system, chopping techniques, vacuum-assisted phaco have improved efficiency and safety in cataract surgery.
The aim of the study was to review the articles assessing corneal endothelium morphology after cataract extraction and lens implantation. Some degree of endothelial cell loss is inevitable after any type of cataract surgery. The endothelium was imaged by non-contact specular microscope. Mean central endothelial cell density, coefficient of variation in cell size and hexagonality was evaluated preoperatively, as well as in different time points after operation. These parameters are the indicators of surgery-induced damage to the cornea. The highest endothelial cell loss was observed during 3 months after surgery. Changes in corneal endothelium morphology had no effect on visual acuity. The more efficient use of ultrasound with power modulation reduced the risk of injury to the eye. Ophthalmic viscosurgical device has protective effect and advantages in terms of anterior chamber stability, lesser intraoperative complications, minimize nuclear-endothelial contact. The mean endothelial cell loss in the studies was 4–18%. Use a torsional or transversal ultrasound was associated with 1.7–2% loss of cells, which is clinically irrelevant.
Słowa kluczowe: śródbłonek rogówki, phakoemulsyfikacja.
Keywords: corneal endothelium, specular microscope, cataract surgery.