Corneal endothelial damage after cataract surgery in eyes with pseudoexfoliation syndrome

Abstract

Purpose: To compare corneal endothelial cell damage and ocular inflammation after cataract surgery in eyes with and without pseudoexfoliation (PXF).

Setting: Hayashi Eye Hospital, Fukuoka, Japan.

Design: Nonrandomized comparative study.

Methods: This study comprised eyes with PXF (PXF group) and age-matched eyes without PXF (non-PXF group) scheduled for phacoemulsification. Preoperatively and 1 and 3 months postoperatively, corneal endothelial cell density (ECD) and central corneal thickness (CCT) were measured using a specular microscope. Flare intensity was measured using a flare meter, and central macular thickness was measured using optical coherence tomography.

Results: Each group had 36 eyes. The mean ECD was significantly lower in the PXF group than in the non-PXF group preoperatively and postoperatively (P≤.0250). The percentage of endothelial cell loss was significantly greater in the PXF group than in the non-PXF group (P≤.0216); the percentage was 9.0% in the PXF group and 3.4% in the non-PXF group 3 months postoperatively. The mean CCT was similar between groups throughout the follow-up period; however, the percentage increase in CCT was significantly greater in the PXF group than in the non-PXF group 1 month postoperatively (P=.0152). Flare intensity and foveal thickness did not differ significantly between groups throughout the follow-up period (P≥.3079).

Conclusions: Corneal endothelial cell loss and a transient increase in CCT were greater after cataract surgery in eyes with PXF than in eyes without PXF. Thus, because the corneal endothelium in eyes with PXF is vulnerable to cataract surgery, careful surgical procedures are necessary.

Financial disclosure: No author has a financial or proprietary interest in any material or method mentioned.