Corneal Endothelial Cell Loss after Phacoemulsification in Eyes with a Prior Acute Angle-closure Attack

Purpose: To evaluate endothelial damage after cataract surgery in eyes affected by an angle-closure attack (ACA) and compareit to that in the unaffected fellow eyes (FEs) of patients with ACA and normal eyes (NEs). Methods: The medical data of eyes affected by ACA, FEs (with no history of acute glaucoma attack), and NEs of patients whounderwent cataract surgery with simultaneous intraocular lens implantation were retrospectively reviewed. Endothelial celldensity (ECD) and central corneal thickness (CCT) measured before surgery and at 1 week, 1 month, and 3 months after surgerywere analyzed, and the percentages of loss in ECD and increase in CCT of the three groups were compared. Results: The study enrolled 140 eyes from 100 patients (50 eyes in the ACA group, 40 eyes in the FE group, and 50 eyes inthe NE group). The mean ECD was significantly lower in the ACA group than in the other groups (p < 0.001). However, the percentageof ECD reduction was not significantly greater in the ACA group than in the other groups (p > 0.05). None of the eyesdeveloped corneal edema at 3 months postoperatively. Moreover, the CCTs of the three groups were similar throughout thefollow-up period (p > 0.05). Conclusions: Phacoemulsification was not associated with greater endothelial cell loss in the ACA group than in the NE andFE groups. This finding shows that ACA history may not contribute to the exacerbation of corneal endothelial damage in cataractsurgery.