Corneal endothelial cell loss and corneal biomechanical characteristics after two-step sequential or combined phaco-vitrectomy surgery for idiopathic epiretinal membrane

TY - JOUR

T1 - Corneal endothelial cell loss and corneal biomechanical characteristics after two-step sequential or combined phaco-vitrectomy surgery for idiopathic epiretinal membrane

AU - Hamoudi, Hassan

AU - Christensen, Ulrik Correll

AU - La Cour, Morten

N1 - © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

PY - 2017/8

Y1 - 2017/8

N2 - Purpose: To assess the impact of sequential and combined surgery [cataract surgery and 23-gauge pars plana vitrectomy (PPV) with peeling] on corneal endothelium cell density (CED) and corneal biomechanical characteristics. Methods: Phakic eyes with epiretinal membrane (ERM) were prospectively allocated to (i) cataract surgery and subsequent PPV (CAT group), (ii) PPV and subsequent cataract surgery (VIT group) or (iii) phacovitrectomy (COMBI group). Eyes were examined at baseline, 1 month after each surgery, and at 3 and 12 months follow-up. Corneal endothelium cell density (CED) was assessed with non-contact specular microscopy. Pachymetry [central cornea thickness (CCT)], keratometry and cornea volume (CV) were measured with Pentacam Scheimpflug camera. Primary outcome was change in CED after 12 months; secondary outcomes were changes in CCT and CV after 12 months. Results: Sixty-two eyes were enrolled and allocated to the three groups. The mean preoperative CED was 2776, 2794 and 2653 cells/mm2, which decreased significantly at 12 months by 15.3, 20.0 and 19.3% in the CAT, VIT and COMBI group. There was no significant difference in percentage cell loss between the groups at final follow-up. The CED decreased significantly after cataract surgery, but was unaffected by PPV. Central cornea thickness (CCT) increased by 10 μm (p = 0.005) and CV by 1.38 mm3 (2.3%, p < 0.001) in the COMBI group. There were no significant differences in CCT or CV between the groups at final follow-up. Conclusion: Combined and sequential surgery in ERM leads to a small decrease in CED. Performing cataract surgery before, after or in combination with vitrectomy did not make any significant difference with respect to final CED, CCT or CV.

AB - Purpose: To assess the impact of sequential and combined surgery [cataract surgery and 23-gauge pars plana vitrectomy (PPV) with peeling] on corneal endothelium cell density (CED) and corneal biomechanical characteristics. Methods: Phakic eyes with epiretinal membrane (ERM) were prospectively allocated to (i) cataract surgery and subsequent PPV (CAT group), (ii) PPV and subsequent cataract surgery (VIT group) or (iii) phacovitrectomy (COMBI group). Eyes were examined at baseline, 1 month after each surgery, and at 3 and 12 months follow-up. Corneal endothelium cell density (CED) was assessed with non-contact specular microscopy. Pachymetry [central cornea thickness (CCT)], keratometry and cornea volume (CV) were measured with Pentacam Scheimpflug camera. Primary outcome was change in CED after 12 months; secondary outcomes were changes in CCT and CV after 12 months. Results: Sixty-two eyes were enrolled and allocated to the three groups. The mean preoperative CED was 2776, 2794 and 2653 cells/mm2, which decreased significantly at 12 months by 15.3, 20.0 and 19.3% in the CAT, VIT and COMBI group. There was no significant difference in percentage cell loss between the groups at final follow-up. The CED decreased significantly after cataract surgery, but was unaffected by PPV. Central cornea thickness (CCT) increased by 10 μm (p = 0.005) and CV by 1.38 mm3 (2.3%, p < 0.001) in the COMBI group. There were no significant differences in CCT or CV between the groups at final follow-up. Conclusion: Combined and sequential surgery in ERM leads to a small decrease in CED. Performing cataract surgery before, after or in combination with vitrectomy did not make any significant difference with respect to final CED, CCT or CV.

KW - Biomechanical Phenomena

KW - Cataract

KW - Cornea

KW - Corneal Endothelial Cell Loss

KW - Epiretinal Membrane

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Male

KW - Middle Aged

KW - Phacoemulsification

KW - Postoperative Complications

KW - Prospective Studies

KW - Time Factors

KW - Visual Acuity

KW - Vitrectomy

KW - Journal Article

KW - Randomized Controlled Trial

U2 - 10.1111/aos.13474

DO - 10.1111/aos.13474

M3 - Journal article

C2 - 28699324

SN - 1755-375X

VL - 95

SP - 493

EP - 497

JO - Acta Ophthalmologica

JF - Acta Ophthalmologica

IS - 5

ER -