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Pre- and postoperative Corneal Endothelial Cell Aanalysis in Cataract Surgery by Confocal Microscopy

Taucherbeck T., Waller W.,
Julius-Maximilians-Universität Würzburg, Universitäts-Augenklinik (Würzburg)

Purpose: For evaluation of endothelial cell density in ophthalmological surgery confocal microscopy is a new option of investigation. We inves-tigated the changes of cell density by confocal microscope after cataract surgery as a new method which was not used therefore up to now. 
Methods: Fifty patients with cataracta provecta (48) and cataracta matura (2) were investigated prospectively. Phacoemulsification and exctracapsular cataract extraction followed by posterior chamber IOL implantation was performed 30 times or 20 times respectively. Examinations were performed with a slit-scanning confocal microscope (Tomey ConfoScan, Modell P2) both preoperative and on the second or third day postoperative respectively (41 times on the second and 9 times on the third day postoperative). Cell density measurements were automatically processed by means of manual correction mode.
Results: The operated eyes showed a significant reduction of cell density (p < 0.000005***) while the control eyes showed no significant change (p=0.79). Endothelial cell loss of the operated eyes from preoperative to the first postoperative day was 203 ± 358 cells/mm² (p = 0.00035***) and 174 ± 329 cells/mm² from the first to the second postoperative day regardless of operating method. After phacoemulsifacation patients showed a cell loss from 2874 ± 380 cells/mm² to 2645 ± 436 cells/mm² on the first postoperative day or 2207 ± 702 cells/mm² on the second postoperative day respectively. After extracapsular cataract extraction cell density decreased from 2770 ± 360 cells/mm² preoperatively to 2634 ± 308 cells/mm² on the first day postoperative or 2544 ± 343 cells/mm² at the second day postoperative respectively. The course of the two operating methods was significantly (p= 0.018*) different.
Conclusions: Confocal microscopy is suitable for analysing corneal endothelial cell density in intraocular surgery.