저밀도내피세포 환자에서 회전진동방식의 초음파유화술을 이용한 백내장 수술 시 단기 임상결과

Short-Term Outcome of Cataract Surgery Using Torsional-Mode Phacoemulsification for Patients with Low Endothelial Cell Counts

Purpose: To evaluate the short-term clinical outcome of cataract surgery using torsional mode phacoemulsification for patients with low endothelial cell density. Methods: Fifty-seven eyes of 52 patients who underwent torsional phacoemulsification and intraocular lens insertion were included in the present study. Patients were divided into groups according to endothelial cell density (ECD). The control group was comprised of patients with more than 2500/mm of ECD and was compared with the low ECD group (LECD) comprised of patients with less than 1600/mm of ECD. The LECD group was further divided into a very low ECD group (VLECD) comprised of patients with less than 1000/mm of ECD, and a PK-VLECD group comprised of patients with less than 1000/mm of ECD after penetrating keratoplasty. Measurement of ECD, cell-size variation coefficient, hexagonality, and central corneal thickness were performed preoperatively and 1 month after surgery. Results: The only one patient who had undergone penetrating keratoplasty with remaining low endothelial density and grade 4 nuclear sclerosis developed overt corneal edema after cataract surgery. No statistically significant differences in the change of endothelial cell characteristics and central corneal thickness before and after surgery were observed between the control and LECD group and between the VLECD and PK-VLECD group. Conclusions: Even in patients with low ECD, torsional phacoemulsification appears to have a similar effect on the short-term change of endothelial cells, suggesting cataract surgery can be conducted with a staged approach when the density of nucleus is moderate or less dense. J Korean Ophthalmol Soc 2011;52(4):434-441