PURPOSE: To compare the efficacy and intraoperative characteristics of DisCoVisc with those of Hyal 2000 (sodium hyaluronate 1.0%) in cataract surgery. METHODS: Cataract surgery was performed on 60 eyes in 49 patients who were diagnosed with moderate cataracts. 30 eyes were performed with DisCoVisc and a control group with 30 eyes using Hyal 2000 (sodium hyaluronate 1.0%). Phacodynamics was evaluated including ultrasound (US) time, mean US intensity, cumulative dissipated energy (CDE), and amount of used balanced salt solution. Corneal endothelium and corneal thickness were measured preoperatively and 1 day and 1 month and 2 months postoperatively. RESULTS: There were no statistically significant differences in phacodynamic parameters in the two groups. The central corneal thickness change from preoperatively to postoperatively in the DisCoVisc group was +0.07 +/- 2.44 microm and Hyal 2000 group +0.84 +/- 2.93 microm (p = 0.032) at 2 months. Corneal endothelial cell loss (ECL)(%) at 2 months was 7.67 +/- 8.01% in DisCoVisc group and 13.23 +/- 15.5% in the Hyal 2000 group (p = 0.005). CONCLUSIONS: There was signicant difference between DisCoVisc and Hyal 2000 in the changes of CCT, ECD (Endothelial cell density). (DisCoVisc is effective and provides advantages both cohesive OVDs and dispersive OVDs).
Cataract ; Corneal Endothelial Cell Loss ; Endothelium, Corneal ; Eye ; Humans

PURPOSE: To access the effect of phacoemulsification using the AquaLase(R) (Alcon Laboratories, TX, U.S.A.) on corneal endothelial cell. METHODS: This study comprised 47 eyes of 43 patients having phacoemulsification with the AquaLase(R). Various corneal endothelial cell parameters, including corneal endothelial cell density, corneal thickness and morphologic change, were evaluated up to 2 months postoperatively. RESULTS: Preoperative mean corneal endothelial cell density was 2818+/-282 cell/mm2. Postoperative mean corneal endothelial cell density was 2682+/-390 cell/mm2 at 1 day, 2701+/-263 cell/mm2 at 1 month and 2721+/-396 cell/mm2 at 2 month. Corneal endothelial cell loss was 4.74%, 4.00% and 3.55% at postoperative 1 day, 1 month and 2 months respectively. There was no statistically significant difference between preoperative and postoperative corneal endothelial cell density (p>0.05). The corneal endothelial cell loss was not increased even though the phacoemulsification time with the AquaLase(R) was increased (p>0.05). Preoperative mean corneal thickness was 559.4+/-37.4 micrometer. Postoperative mean corneal thickness was 586.9+/-35.1 micrometer at 1 day, 573.3+/-30.1 micrometer at 1 month and 554.9+/-26.7 micrometer at 2 month. There was a significant increase in corneal thickness at postoperative 1 day (p=0.001). However, there was no statistically significant difference of corneal thickness between preoperative and postoperative 1 month and 2 month (p>0.05). CONCLUSIONS: The phacoemulsification with the AquaLase(R) dose not cause the significant corneal endothelial cell density and corneal thickness change postoperatively.
Cornea* ; Corneal Endothelial Cell Loss ; Endothelial Cells ; Endothelium* ; Humans ; Phacoemulsification*

PURPOSE: To assess the effect of pars plana vitrectomy and gas tamponade on corneal endothelial cell density. METHODS: The corneal endothelial cell density in 145 eyes that underwent pars plana vitrectomy was examined with a noncontact specular microscope 3 months pre- and post-operation. The subjects were divided as follows: Group 1 (32 eyes) underwent pars plana vitrectomy, group 2 (26 eyes) underwent pars plana vitrectomy combined with gas tamponade, group 3 (34 eyes) underwent pars plana vitrectomy combined with phacoemulsification and group 4 (48 eyes) underwent pars plana vitrectomy combined with phacoemulsification and gas tamponade. The changes in corneal endothelial cell density between groups was compared. RESULTS: The mean endothelial cell loss was more significant in group 2 than in group 1 (p = 0.012), and there was no difference between groups 3 and 4 (p = 0.063). However, after excluding 6 eyes that had blood in the center of the corneal endothelium as a result of being in the prone position following gas tamponade, the mean endothelial cell loss in group 2 was not less than in group 1. In eyes with blood in the corneal endothelium, endothelial cell loss significantly increased (p < 0.001). CONCLUSIONS: The results of this study suggest that ophthalmic surgeons should attempt to carefully control bleeding and sufficiently irrigate the vitreous during pars plana vitrectomy combined with gas tamponade.
Corneal Endothelial Cell Loss ; Endothelial Cells ; Endothelium, Corneal ; Eye ; Hemorrhage ; Phacoemulsification ; Prone Position ; Vitrectomy

PURPOSE: To access the effect of phacoemulsification, using Neosonix(R) (Alcon Laboratories, TX, USA), on the cornea and lens opacity. METHODS: This study involved 42 eyes of 37 patients who underwent phacoemulsification using the Neosonix from December 2005 through March 2006. We measured the density and the thickness of lenses using a Scheimpflug camera and evaluated the correlation between the density and the phaco time. To evaluate the effects of Neosonix(R) on the corneal endothelium, we measured various corneal endothelial cell parameters, including corneal endothelial cell density, corneal thickness, and morphologic changes up to two months postoperatively. RESULTS: The preoperative mean values of lens density for the anterior cortex, nucleus, and posterior cortex were 105.86+/-34.99 CCT, 82.17+/-35.14 CCT, and 77.88+/-52.98 CCT, respectively. The mean phacoemulsification time was 48.67+/-29.79 seconds and increased significantly, according to the increase of the densities of the lens nucleus and cortex (p<0.01). Postoperative mean corneal endothelial cell density was 2741+/-474 cell/mm2 at one day, 2757+/-447 cell/mm2 at one month, and 2765+/-422 cell/mm2 at two months. Corneal endothelial cell loss was 4.39%, 3.83%, and 3.56% at one day, one month, and two months postoperatively, respectively. There was no statistically significant difference between the preoperative and postoperative values of corneal endothelial cell density (p>0.05). CONCLUSIONS: The phacoemulsification time using oscillation device significantly increased as the density of the lens cortex and nucleus increased, and there was no statistically significant difference between the preoperative and postoperative values of corneal endothelial cell density.
Cataract ; Cornea* ; Corneal Endothelial Cell Loss ; Endothelial Cells ; Endothelium, Corneal ; Humans ; Phacoemulsification*

Phaco-drill technuque, is a method of phacoemulsifying cataractous lens with a bevel down position of phacotip, thus concentrating vacuum and ultrasonic power on center of the lens. This enables the phacoemulsification to be completed with a lower setting of energy. In this study, we evaluated the efficacy of the phaco-drill technique by measuring corneal endothelial cell damage. Since August 1997, we examined 170 patients who had under-gone phacoemulsification using phaco-drill technique, for uncorrected visual acuity, number, shape and size of corneal endothelial cell, and corneal thickness before and 2 months after surgery. the mean visual acuity was 0.26+/-0.24 before operation,and the mean visual acuity at 1 day and 2 months postlperatively was 0.59+/-0.32 and 0.82+/-0.26, respectively. The mean time of phacoemulsification was 58+/-41 seconds, and the average power(surgeon mode)was 8.6+/-0.26%. Mean volume of irrigating solution used in the operation was 116.12+/-52.10cc and that of aspirated solution was 63.34+/-30.37cc. The number of endothelial cells decreased from 2450+/-308.6 cell/mm2 before operation to 2234+/-372.2 cell/mm2 2 months after operation(9.2% decrease). The size of endothelial cells increased from 33.78+/-5.53/micrometer(2) before operation to 34.70+/-5.79/micrometer(2) 2 months after the operation(2.7% increase). The regularity of the cells (hexagonality) showed a decrease of 3%, from 57.47+/-10.16 before operation to 55.81+/-10.49% 2 months after the operation. The corneal thickness increased from 528+/- 36micrometer before operation to 590+/-8micrometer 1 dat(11.7% increase) and 531+/-4micrometer(0.5% increase) after the operation. From the results of this study we suggested that phaco-drill technique might be one of effective methods of phacoemulsification for less damage of corneal endothelial cells and less fluid consumption.
Cataract ; Corneal Endothelial Cell Loss ; Endothelial Cells ; Endothelium, Corneal* ; Humans ; Phacoemulsification ; Ultrasonics ; Vacuum ; Visual Acuity

The aim of this study was to evaluate the influence of intraocular 1% lidocaine as an adjunct to topical anesthesia on corneal endothelial cell during phacoemulcification. We evaluated 38 patients(50 eyes). All patients underwent phacoemulsification and PCL implantaion. Twenty five eyes were used intraocular 1% lidocaine and topical anesthesia and others used only topical anesthesia. Endothelial cell density was examind preoperatively, and at 1 day, 1 week, 1 and 2 months postoperatively by specular microscopy. The difference of preoperative endothelial cell density between two groups was not statistically significant. In lidocaine-used group, the average endothelial cell loss was 7. 6%, 9. 2%, 10.4%, 10.6%at 1 day, 1 week, 1 and 2 months. In non used group, the average endothelial cell loss was 7. 4%, 9. 4%, 9. 9%, 11. 7%at 1 day, 1 week, 1 and 2 months. The difference of postoperative endothelial cell density between two groups was not statistically significant(P>0.1). From these results, we conclude that the intraocular lidocaine infusion for anesthesia had little effect on the corneal endothelial cell loss.
Anesthesia ; Corneal Endothelial Cell Loss ; Endothelial Cells ; Endothelium, Corneal* ; Humans ; Lidocaine* ; Microscopy ; Phacoemulsification*

PURPOSE: To evaluate corneal endothelial cell changes in Optisol-GS(R) according to enucleation time at different storage temperatures after death. METHODS: Eight rabbit cadavers (16 eyes) were stored at -3 degrees C and room temperature, and enucleation was performed 10 and 24 hours postmortem. The samples were divided into four groups (Group 1 was -3 degrees C, 10 hours, Group 2 was room temperature, 10 hours, Group 3 was -3 degrees C, 24 hours, and Group 4 was room temperature, 24 hours). The corneas were stored in Optisol-GS(R) at 4 degrees C, and we measured corneal endothelial cell density and thickness by specular microscopy on days 1, 3, 5, 7, 10, and 14 of preservation. RESULTS: The densities and thicknesses of corneal endothelial cells of each of the four groups after enucleation showed no significant difference. Corneal endothelial cell density acceptable for penetrating keratoplasty (CD>2500 cells/mm2) was found in groups 1 and 3 until 14 days, in group 2 until 10 days, and in group 4 until 7 days. In particular, eyes stored at -3 degrees C had less corneal endothelial cell loss than at room temperature after 7 days and 14 days (P<0.05). CONCLUSIONS: This study demonstrated that when rabbit cadavers were stored at -3 degrees C, corneas could be preserved in Optisol-GS(R) for 14 days, even if the eyeballs from which they were prepared were extracted within 24 hours postmortem. Within 24 hours postmortem, the storing temperature of the cadavers was found to be more important than the enucleation time for the survival of corneal endothelial cells.
Cadaver ; Cornea ; Corneal Endothelial Cell Loss ; Endothelial Cells ; Endothelium, Corneal ; Eye ; Keratoplasty, Penetrating ; Microscopy

To evaluate the changes of the central corneal endothelial cell density and morphology after phacoemulsification and foldable silicone intraocular lens(IOL) implantation through a 3.2mm temporal clear corneal incision under topical anesthesia. On 43 patients(43 eyes) who had no systemic and ocular disease to influence the status of corneal endothelium , central corneal thickness, central corneal endothelial celldensity, pleomorphism index and polymegathism index, there was significant increase at 1 day postoperatively and recovery to preoperative state at 2 months poeroperatively. Central corneal endothelial cell losses were 8.92% at 1 day postoperatively and 15.95% at 2 months poeroperatively(p=0.00) and statistically significant increase of polymegathism index was noted at 1 day and 2 months poeroperatively. However no significant difference in central corneal endothelial cell loss and polymegathism index was noted at 6 months postoperatively. From the above results, we concluded that the phacoemulsification through a temporal clear corneal incision under topical anesthesia decreases the central corneal endothelial cell density and increase polymegathism index of the corneal endothelial cells, but these changes become stabilized after postoperative 2 months. Also proper control group must be set up to detect causes of corneal endothelial cell loss and it is neede to estalblish a new criteria for safe corneal endothelial cell density.
Anesthesia* ; Corneal Endothelial Cell Loss ; Endothelial Cells* ; Endothelium, Corneal ; Phacoemulsification* ; Silicones

OBJECTIVETo evaluate the feasibility of using cultured corneal endothelial cell (CECs) transplantation for cornea endothelium cell destruction with Gelatin membrane as the carrier in rabbits.

METHODSThe cultured CECs were labeled by Brdu and subcultured in vitro on glutaraldehyde-fixed Gelatin membranes and then the membranes were glued by alpha-cyanoacrylate alkyl to 7.00 mm autologous rabbit corneal bottons whose endothelium were mechanically removed previously. The buttons were sutured in place. With this method the right eyes of 21 rabbits were transplanted with CECs, and the right eyes of another 17 rabbits were transplanted with non-cells carrier as controls. The rabbits were bred and observed by slit microscopy and confocal microscopy at 1, 2, 4, 8, and 12 weeks after surgeries. Also, introcular pressure and corneal thickness were measured by Perkin's tonometer and ultrasonic pachymeter. After 12 weeks, all the animals were sacrificed and the grafts were examined by light microscopy and electronic microscopy.

RESULTSCECs grew well on the gelatine memberane, and formed confluent monolayers in 3-5 days; the cell density reached as high as 2700 cells/mm2. After 2 weeks of operation, all corneal buttons were edema and began to be opaque. The control eyes remained opaque throughout the observation period. In eyes with CECs transplanted, the grafts began to be clear and thin 4 weeks after operation. The cell density of grafts decreased along with time, and the mean cell density of CECs transplantation buttons was (2023.3 +/- 330.3) cells/mm2 12 weeks after operation. The transplanted cells were stained with the anti-Brdu monoclonal antibody.

CONCLUSIONIt is feasible to culture and translate CECs with the Gelatin membrane.

Animals ; Cells, Cultured ; Corneal Endothelial Cell Loss ; pathology ; therapy ; Endothelial Cells ; transplantation ; Endothelium, Corneal ; cytology ; Rabbits

PURPOSE: To analyze the influence of preoperative corneal endothelial status on postoperative corneal endothelium density after cataract surgery. METHODS: We evaluated 228 eyes of 158 patients who underwent cataract surgery. Corneal endothelial status and central corneal thickness were measured before surgery and 1 day, 1 month, 3 months and 6 months after surgery. Patients were classified by preoperative endothelial cell density (three groups) and their coefficients of variation and hexagonality (two groups). Clinical parameters, including corneal endothelial cell losses, visual acuity, intraocular pressure, spherical equivalent refraction and central corneal thickness were measured to compare the intergroup indices. RESULTS: There were no significant differences in corneal endothelial cell losses at 1 day, 1 month, 3 months and 6 months after surgery in any of the groups based on corneal endothelial cell density. There were increases in corneal thickness at 1 day and 1 month after surgery that were significantly higher in the low-endothelial cell density group than the 2,000-2,500 cells/mm² cell density group (p < 0.05), but there were no differences after the 3-month time point. There were no significant differences in clinical parameters for the coefficient of variation and hexagonality groups until 6 months after surgery. CONCLUSIONS: We observed reversible corneal edema in the low endothelial group; however, there were no significant intergroup differences in corneal endothelial cell loss due to preoperative corneal endothelial status. Our results suggest that cataract surgery is relatively safe for patients with morphologically abnormal corneal endothelium and/or low endothelial density; the safety is primarily due to improved equipment and surgery techniques.
Cataract* ; Cell Count ; Corneal Edema ; Corneal Endothelial Cell Loss ; Endothelial Cells ; Endothelium, Corneal* ; Humans ; Intraocular Pressure ; Phacoemulsification ; Visual Acuity