각막이식 삼중수술 시 인공수정체 삽입 시점에 따른 각막 내피 생존 비교

The Effect of Intraocular Lens Insertion Sequence during the Triple Procedure on Corneal Endothelial Cell Survival

Purpose: To evaluate the differences in corneal endothelial cell density in patients undergoing intraocular lens insertion at 2 different sequences during the triple procedure. Methods: The present retrospective study divided 37 eyes of 37 patients and into 2 groups: trephination, phacoemulsification and intraocular insertion, followed by graft suturing (20 eyes, Group I), and trephination, phacoemulsification, graft suturing leaving 3 mm gap, followed by intraocular lens insertion and suturing of the gap (17 eyes, Group II). Intraocular pressure, corneal thickness, and endothelial cell density were measured for 3 months postoperatively. Results: No significant difference in intraocular pressure between the 2 groups (p = 0.14) was observed. However in Group II, the mean corneal thickness showed a greater decrease (p = 0.02) during the 3 months following surgery, and the mean corneal endothelial cell density in this group was higher at 1, 2, and 3 months postoperatively than that of Group I (p = 0.01, 0.02 and 0.04 respectively). There were no significant difference in the rate of endothelial cell loss during the postoperative period between the 2 groups. Conclusions: The anterior chamber formation before intraocular lens insertion in the triple procedure is hypothesized to decrease corneal endothelial cell loss by minimizing mechanical contact with intraocular structures or intraocular lenses during surgery. J Korean Ophthalmol Soc 2011;52(8):916-921