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Year : 2020  |  Volume : 33  |  Issue : 4  |  Page : 1218-1225

Evaluation of corneal endothelial changes after posterior capsule rupture during phacoemulsification using specular microscope

Department of Ophthalmology, Faculty of Medicine, Menoufia University, Menoufia, Egypt

Correspondence Address:
Hebatallh M. T. Nada
MSC, Faculty of Medicine, Yaseen Abdelghafar Street, Shebin Elkom
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/mmj.mmj_168_20

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Background Phacoemulsification cataract surgery is now the technique of choice for routine cataract extraction. However, posterior capsule rupture (PCR) during phacoemulsification cataract surgery remains an important complication because it may lead to poor visual outcome. Objective The aim of this study was to evaluate the effect of PCR during cataract extraction by phacoemulsification on the corneal endothelium using a specular microscope. Patients and methods A total of 50 patients with age range between 45 and 65 years were enrolled in this study during a period of 1 year. Anterior chamber depth measurement was done. Preoperatively, anterior chamber depth (mm) was recorded using intraocular lens master. Central corneal thickness (CCT) and the endothelial cell counts were measured using a noncontact specular microscope preoperatively and postoperatively. Results We compared the preoperative details and contrasted the 1- and 3-month postoperative outcomes, including best -corrected visual acuity, endothelial cell loss, CCT, coefficient of variation, and hexagonality. We found that the majority of our patients (92%) experienced improved best-corrected visual acuity at 3 months after phacoemulsification. Our patients had an increased CCT 1 month postoperatively, with a significant rise from baseline. When polymegathism was evaluated, we observed that coefficient of variation increased significantly from baseline, and declined slightly by 3 months postoperatively. Regarding cell count density, we observed a significant decrease of cell density following the operation after 1 month and a much more decrease after 3 months. Conclusion We concluded that PCR during phacoemulsification resulted in significant corneal endothelial damage; however, it provided better visual acuity. For better outcomes, early recognition of PCR is advised, besides immediate proper management to minimize the endothelial damage.

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