Objective: To investigate the long-term changes in corneal endothelium following uncomplicated phacoemulsification surgery and to investigate the effects of phaco parameters and anterior chamber flare (ACF) on endothelial cell parameters. Material and Methods: This retrospective study included 47 eyes that underwent uncomplicated phacoemulsification and intraocular lens implantation. The endothelial cell density (ECD), central corneal thickness (CCT), coefficient of variation (CV) and hexagonal cell percentage (HEX) were measured by specular microscopy before and 6 months after surgery. Preoperative and postoperative 1st week ACF was recorded by laser flare meter. The relationship between the changes in endothelial cell parameters and phaco parameters total ultrasound (US) time, cumulative dissipated energy (CDE) and the ACF in the 1st week were evaluated. Results: Preoperatively, the ECD was 2,428.2±302.8 cells/mm² and 2,314.1±376.7 cells/mm² at month 6 (p=0.04). The endothelial cell loss (ECL) was 4.6% at the 6th month. There was no significant postoperative change in CCT, CV and HEX (p>0.05). Postoperative ACF was significantly elevated at week 1; however, it gradually decreased to near baseline by month 6. Total CDE positively correlated with ECD reduction at month 6 (p=0.007, r=0.38); US time with ACF at postoperative week 1 (p=0.004, r=0.34). There was a positive correlation between ACF and ECL (p=0.01, r=0.36) at week 1. Conclusion: Total CDE and US time are positively correlated with both anterior chamber inflammation and ECL. These findings highlight the importance of careful intraoperative management and postoperative monitoring to minimize endothelial cell damage and inflammation.
Koser et al. (Thu,) studied this question.