Effect of Hydroxypropylmethylcellulose versus Sodium Hyaluronate on corneal endothelial cell count in patients undergoing cataract surgery by phacoemulsification

2021 ◽  
Vol 15 (8) ◽  
pp. 2064-2066
Author(s):  
Faisal Anwar ◽  
Mohammad Hasan Bokhari ◽  
Muhammad Tahir Ghaffar ◽  
Ahsan Irshad ◽  
M. Shoaib Khan ◽  
...  
Keyword(s):  
Endothelial Cell ◽  
Cell Count ◽  
Hydroxypropyl Methylcellulose ◽  
Sodium Hyaluronate ◽  
Cell Loss ◽  
Corneal Endothelial Cell ◽  
Endothelial Cell Count ◽  
Significant Difference ◽  
Group A ◽  
Group B

Objective: To compare the effect of Hydroxypropyl methylcellulose versus Sodium Hyaluronate on corneal endothelial cell count in patients undergoing cataract surgery by phacoemulsification. Design: It was a randomized clinical trial. Study Settings: This study was conducted at the Eye Unit III, Mayo Hospital / KEMU, Lahore over 12 months period from June 2014 to May 2015. Hypothesis: There is a significant difference in protective effect on corneal endothelial cell loss with dispersive (Hydroxypropyl methylcellulose) viscoelastic agent as compared to cohesive (sodium hyaluronate) viscoelastic agent used during phacoemulsification with intraocular lens for the treatment of cataract. Material and Methods: Total 80 patients from both the genders aged between 40-70 years with cataract undergoing phacoemulsification surgery were involved in this study. Two equal treatment groups were made by random allocation. Patients in Group-A (n=40) received Hydroxypropyl methylcellulose as viscoelastic agent while patients in Group-B (n=40) received treatment with Sodium Hyaluronate. Surgery was carried out by phacoemulsification technique and follow-up was done at first week, 1st month and 3rd month post-operatively. Data was collected in terms of endothelial cell count by noncontact specular microscope. Results: Patients age was in the range of 40 to 70 years with a mean of 57.26 ± 8.00 years. There were 31 (38.75%) females and 49 (61.25%) male patients with a female to male ratio of 1.6:1. Both the groups had no statistically significant difference in the mean corneal cell count before surgery (2839.67±368.71 cells/mm2 vs. 2801.36 ± 332.52 cells/mm2; p-value= 06.27). Post-operative mean corneal cell count at 1 week, 1 month and 3 months was significantly higher in patients in Group-A compared to Group-B. Similarly, significant difference was noted across various subgroups of both the groups on the basis of patient’s age and gender. Conclusion: This study concluded that there is less corneal endothelial cell loss with dispersive Hydroxypropyl methylcellulose viscoelastic agent as compared to cohesive sodium hyaluronate viscoelastic agent used during phacoemulsification surgery with intraocular lens implant for the treatment of cataract. Keywords: Cataract, phacoemulsification, viscoelastic agents, corneal, endothelial cell.

scholarly journals Comparisons of Visual and Surgical Outcomes after Reuse or Replacement of Dislocated in-the-Bag Intraocular Lens

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Takayuki Baba ◽  
Tomohiro Nizawa ◽  
Toshiyuki Oshitari ◽  
Shuichi Yamamoto
Keyword(s):  
Visual Acuity ◽  
Endothelial Cell ◽  
Intraocular Lens ◽  
Refractive Error ◽  
Surgical Outcomes ◽  
Case Series ◽  
Cell Loss ◽  
Significant Difference ◽  
Group A ◽  
Group B

Purpose. To compare the visual and surgical outcomes after a reuse or a replacement of a dislocated in-the-bag intraocular lens (IOL). Methods. This was a retrospective, nonrandomized case series at a single ophthalmological institution. Cases with an in-the-bag dislocation of an IOL were treated by pars plana vitrectomy and the reuse or the replacement of the IOL. The lens was held by intrascleral fixation of the haptics of the IOL under both conditions. The same dislocated IOL was reused in 6 eyes (group A) or it was replaced with another IOL in the other 9 eyes (group B). The pre- and postoperative parameters analyzed included the visual acuity, refractive error, corneal endothelial cell density, and intraocular pressure (IOP). Results. There was no significant difference between the two groups in the postoperative visual acuity (P=0.388), refractive error (P=0.955), IOP (P=0.529), and endothelial cell loss (P=0.940). A breakage or a tilting of the IOL was observed and required replacement in three eyes in the reuse group (P=0.044). Conclusions. Half of the cases with reused in-the-bag dislocated IOL had a breakage or a tilting of the IOL. The replacement of the in-the-bag dislocated IOL is better than the reuse of the IOL with intrascleral haptics fixation.

Comparison between the protective effect of Ophthalmic Viscoelastics on the corneal endothelium in phacoemulsification

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
S M A Saleh ◽  
R M F Elghazawy ◽  
A I Elawamry ◽  
R G Zaki
Keyword(s):  
Visual Acuity ◽  
Endothelial Cell ◽  
Protective Effect ◽  
Cell Count ◽  
Corneal Endothelium ◽  
Hydroxypropyl Methylcellulose ◽  
Methyl Cellulose ◽  
Endothelial Cell Count ◽  
Significant Difference ◽  
Group 2

Abstract Background Phacoemulsification is one of the most common surgical interventions done worldwide; the ultrasound power used to emulsify and remove the cataractous lens is hazardous to corneal endothelium and can lead to permenant damage. Thats why ophthalmic viscoelastics have been developed and used to protect the corneal endothelium and ensure safety of intraocualr surgeries. Objective To study the effect of different concentrations of methyl cellulose on the corneal endothelium during phacoemulsification using specular microscopy. Patients and Methods Sixty patients with Immature Senile Cataract (IMSC) are equally distributed into two groups according to the concentration of Hydroxypropyl Methylcellulose (HPMC) used during phacoemulsification. In the first group HPMC 2% was used and in the second group HPMC 2.4% was used. Preoperative and one month postoperative examination was done including visual acuity testing, slit lamp examination using Topcon SL-3C, intraocular pressure measurement using Goldmann Applanation Tonometer (GAT), fundus examination, corneal edndothelium assessment by Tomey Specular Microscope EM-3000. Results Preoperatively, no significant difference was observed in age, sex, visual acuity, introcular pressure and endothelial cell count among the two groups. Postoperatively, the two groups had a significant decrease in endothelial cell count, but the decrease was less in group 2 using Methyl cellulose 2.4% (13.494%) than in group 1 using Methyl cellulose 2% (14.515%).There was an equal and significant increase in visual acuity in the two groups. Discussion Many studies have been done to compare the efficacy of different viscoelastics (OVDs) in the protection of corneal endothelium during phacoemulsification. In our study we compared the protective effect of two different concentrations of HydroxyPropyl MethylCellulose (2% &2.4%) on the corneal endothelium during phacoemulsification. We compared the demographic data as regarding age and sex of the patients in the two groups, also we compared the preoperative endothelial cell count in the two groups using Specualr Microscopy and the result showed no significant difference between the 2 groups. The endothelial cell loss was comparable in the 2 groups, in group 1 it was 362.267 ± 52.020 (14.515 % ± 1.458) and in group 2 it was 335.667 ± 21.170 (13.494% ±0.667) with slightly better protection in the second group. So these results shows that HPMC 2.4% gives better protection than HPMC 2% on corneal endothelium during phacoemulsification on terms of the postoperative endothelial cell count and the endothelial loss after phacoemulsification. Many studies have been done to compare the efficacy and the protective effect of different viscoelastics during phacoemulsification for example the studies done by Miller et al, Maar et al, Vajpayee et al and Storr-Paulsen et al, these studies showed results similar to our study as regards the protective effect of methyl cellulose with its different concentrations on the corneal endothelium during phacoemulsification, so both concentrations (2% and 2.4%) can be used safely and effectively in phacoemulsification to decrease the endothelial loss and ensure patients safety. Conclusion Methyl cellulose 2.4% and Methyl cellulose 2% were comparable in their ability to protect the corneal endothelium during phacoemulsification, in general both viscoelastics can be efficiently and safely used in performing phacoemulsification.

scholarly journals Corneal status following modified Blumenthal technique of manual small incision cataract surgery (MSICS) compared to phacoemulsification in treatment of grade III or more nuclear sclerosis-cohort study

2015 ◽  
Vol 7 (1) ◽  
pp. 47-51 ◽  
Author(s):  
K Jain ◽  
K PS Malik ◽  
S Gupta
Keyword(s):  
Endothelial Cell ◽  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Cell Loss ◽  
Specular Microscopy ◽  
Endothelial Cell Loss ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Grade Iii

Objective: To evaluate the endothelial cell loss and central corneal thickness in modified Blumenthal technique of MSICS and Phacoemulsification. Method: A prospective study in which 50 cases of nuclear sclerosis grade III (LOCS III) or more were randomized in two groups of 25 each. Group A underwent modified Blumenthal MSICS. Lens expression was facilitated by viscoelastic injection through ACM and scleral pressure by iris repositor. Group B underwent 2.8 mm phacoemulsi¿cation. Specular microscopy and pachymetry were done at 1st POD, 1st, 3rd and 6th week.Results: No significant difference in endothelial cell loss and central corneal thickness between group A and group B (p > 0.05) was found.Conclusion: This technique of MSICS is not inferior, an innovative, safe and highly effective in hard cataracts.

Bimanual femtosecond laser-assisted cataract surgery compared to standard bimanual phacoemulsification: A case–control study

2018 ◽  
Vol 29 (6) ◽  
pp. 629-635 ◽  
Author(s):  
Gian Maria Cavallini ◽  
Elisa Fornasari ◽  
Michele De Maria ◽  
Andrea Lazzerini ◽  
Luca Campi ◽  
...  
Keyword(s):  
Endothelial Cell ◽  
Femtosecond Laser ◽  
Cataract Surgery ◽  
Cell Count ◽  
Low Energy ◽  
Endothelial Cell Count ◽  
Group A ◽  
Induced Astigmatism ◽  
Group B ◽  
Surgically Induced

Purpose: To evaluate the efficacy and safety of bimanual, low-energy femtosecond laser-assisted cataract surgery with 1.4-mm microincisions compared to standard bimanual phacoemulsification (bimanual microincision cataract surgery). Design: Prospective, non-randomized comparative case series. Methods: Bimanual femtosecond laser-assisted cataract surgery with microincisions was performed on 80 eyes (Group A) with the low-energy Ziemer LDV Z8; a matched case–control series of 80 eyes performed with standard bimanual microincision cataract surgery technique was selected for comparison (Group B). All interventions were performed by the same experienced surgeon. Intraoperative parameters were recorded as well as intra- and postoperative complications. Best corrected visual acuity, surgically induced astigmatism, central corneal thickness and endothelial cell count were evaluated before surgery and at 1 and 3 months post intervention. Results: The mean effective phaco times were 3.79 ± 2.19 s (Group A) and 4.49 ± 1.84 s (Group B) (p = 0.041). No major intra- or postoperative complications occurred. An overall significant mean best corrected visual acuity improvement was noted at 3 months, but was not statistically different between the groups. No significant changes were observed for surgically induced astigmatism or corneal pachymetry. A significant loss of endothelial cell count in both groups was detected at 3 months, with Group A reporting a significantly lower endothelial cell count loss compared to Group B (p = 0.009). Conclusion: Bimanual, low-energy femtosecond laser-assisted cataract surgery with 1.4-mm microincisions by an expert surgeon was proven to be safe and effective in this study. This technique has advantages compared with standard bimanual microincision cataract surgery in terms of endothelial preservation.

scholarly journals Mean Corneal Endothelial Cell Loss in Type 2 Diabetic Cataract Patients After Phacoemulsification.

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Syed Abdullar Mazhar ◽  
Sehar Zahid ◽  
Junaid Hanif ◽  
Muhammad Asharib Arshad ◽  
Rana Naveed Iqbal
Keyword(s):  
Type 2 Diabetes ◽  
Endothelial Cell ◽  
Cell Count ◽  
Cell Loss ◽  
Corneal Endothelial Cell ◽  
P Value ◽  
Specular Microscopy ◽  
Endothelial Cell Loss ◽  
Endothelial Cell Count

Purpose:  To assess the mean corneal endothelial cell loss after Phacoemulsification in patients of type 2 diabetes. Study Design:  Cross-sectional study. Place and Duration of Study:  Layton Rahmatullah Benevolent Trust Free Eye and Cancer Hospital for a period of six months, from May 2015 to November 2015. Material and Methods:  Three hundred and fifty-five patients were selected by non-probability convenience sampling. Patients with cataract, diagnosed at least after 6 months of diagnosis of type 2 diabetes were included in this study. Patients with any systemic disease or ocular disease other than senile cataract were excluded from the study. Endothelial cell count was measured with Specular microscopy one day before surgery. One experienced surgeon with post-graduate experience of at least five years performed all the procedures. Follow up by specular microscopy was done at 6 weeks after phacoemulsification. Statistical analysis was done using SPSS version 23. Results:  Mean age of the patients was 59.32 ± 7.60 years. There were 41.97% males and 58.03% females. Mean endothelial cell count before phacoemulsification was 2177.21 ± 591.078 and 6 weeks after surgery was 1984 ± 597.51. Age, gender, laterality, duration of diabetes and type of cataract was not significantly related with endothelial cell loss, p-value > 0.05. Mean endothelial cells loss was higher in patients with HbA1c > 7 as compared to those with HbA1c < 7 (p-value = 0.01). Conclusion:  Patients with poor control of diabetes have higher endothelial cell loss after phacoemulsification than patients with good control.

HAEMOSTATIC PARAMETERS, ENDONEURIAL OXYGEN TENSION AND SURAL NERVE HISTOLOGY IN DIABETES MELLITUS

1987 ◽  
Author(s):  
I Ford ◽  
P G Newrick ◽  
R Malik ◽  
F E Preston ◽  
J D Ward ◽  
...  
Keyword(s):  
Endothelial Cell ◽  
Oxygen Tension ◽  
Sural Nerve ◽  
Clot Lysis ◽  
Diabetic Patients ◽  
Membrane Thickness ◽  
Basement Membrane Thickness ◽  
Significant Difference ◽  
Group A ◽  
Group B

We have examined coagulation parameters in 15 neuropathic (Group A) and 10 complication-free diabetic patients (Group B). Venesection and sample testing were performed under standard conditions. Group A underwent sural nerve biopsy and 14 also had measurements of endoneurial oxygen tension. Factor VIII related antigen was higher in Group A (l-617u/ml ± 0.67) compared to Group B (0.944u/ml ± 0.26); (mean ± SD; p<.0.05) perhaps suggesting endothelial cell damage, although this did not correlate with capillary basement membrane thickness or endothelial cell number nor with endoneurial oxygen levels. Platelets from Group A were more sensitive to arachidonate than those of Group B, showing aggregation thresholds in platelet rich plasma of 0.36 ± 0.17mM and 0.57 ± 0.9mM respectively compared with 0.65 ± 0.37mM in non-diabetic controls.Platelets from Group A subjects also produced more thromboxane B2 in response to arachidonate than Group B or normal controls (37.95 ± 27.5; 25.5 ± 13.0; 16.55 ± 15-5pmol/107 platelets). Blood fibrinolytic capacity measured by euglobulin clot lysis time, was diminished in NIDDs (post-occlusion ECLT 165.7 mins ± 116.0), compared to IDDs (55.5 ± 34.5) (p<0.05) due at least in part to excess of tissue plasminogen-activator inhibitor, although we found no significant difference in ECLT between Group A and Group B. Interaction between haemostatic and microvascular abnormalities in diabetes may contribute to the pathogenesis of diabetic neuropathy.

Corneal Endothelial Cell Count in Keratoconus Patients After Contact Lens Wear

2004 ◽  
Vol 30 (1) ◽  
pp. 54-58 ◽  
Author(s):  
Charles R. Edmonds ◽  
Shu-Fen Wung ◽  
Marla J. Husz ◽  
Bart Pemberton
Keyword(s):  
Endothelial Cell ◽  
Cell Count ◽  
Contact Lens ◽  
Corneal Endothelial Cell ◽  
Contact Lens Wear ◽  
Endothelial Cell Count ◽  
Lens Wear

Inhibitory effect of adenosine on intimal hyperplasia and proliferation of smooth muscle cells in a carotid arterial anastomosis animal model

Vascular ◽  
2014 ◽  
Vol 23 (2) ◽  
pp. 124-131 ◽  
Author(s):  
Gokhan Albayrak ◽  
Erdem Silistreli ◽  
Bekir Ergur ◽  
Sule Kalkan ◽  
Ozalp Karabay ◽  
...  
Keyword(s):  
Cell Proliferation ◽  
Smooth Muscle ◽  
Endothelial Cell ◽  
Neointimal Hyperplasia ◽  
Inhibitory Effect ◽  
Endothelial Cell Proliferation ◽  
Positive Staining ◽  
Significant Difference ◽  
Group A ◽  
Group B

Purpose The effect of adenosine (9-β-0-ribifuranosyladenine) on the endothelial cell proliferation and neointimal hyperplasia is investigated in the rabbit carotid artery anastomosis model. Methods Twenty-eight New Zealand white rabbits were arranged in four groups of seven animals each. The right carotid arteries of each animal were transsected and re-anastomosed. The left sides remained as control. In Group A, no medication was used. In Group B, subcutaneous Adenosine was applied for 3 days. In Group C, the same dose was applied for 7 days, and in Group D for 21 days. After 28 days, the luminal diameters, luminal areas, intima/media ratios were all measured by using histopathological evaluation. Findings The mean luminal diameters and areas of the four groups were smaller than the control ones. Massive thickening of smooth muscle cell proliferation and dense intensifying in the connecting tissues were observed most prominently in Group A, in decreasing degrees within other groups. Intima/media ratio was highest in Group A. Scoring the quantity of e-NOS positive staining also revealed a significant difference between the experimental groups and their control associates. Conclusion The process of endothelial cell proliferation and neointimal hyperplasia can be significantly reduced by the use of adenosine.

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