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FACTORS INFLUENCING CORNEAL ENDOTHELIAL CELL CHANGES AFTER PHACOEMULSIFICATION IN PRIMARY ANGLE-CLOSURE GLAUCOMA USING COMBINED ODVS
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Abstract
Objective: To evaluate the factors affecting corneal endothelial cell changes after Phaco surgery with or withoutgoniosysechialysis in patients with primary angle-closure glaucoma using a combination of cohesive and dispersive ophthalmic viscoelastic devices (OVDs) at the Glaucoma Department of the Vietnam National Eye Hospital.Subjects and Methods: The study included patients with primary angle-closure glaucoma and cataract who were indicated for Phaco surgery, with or without combined goniosysechialysis. This was a prospective interventional clinical study conducted at the Glaucoma Department from August to December 2024 at the Vietnam National Eye Hospital.Results: The study was conducted on 62 eyes from 54 patients. There was a low correlation between nucleus hardness and endothelial cell loss (ECL) (r = 0.02). At two months postoperatively, the difference between the two groups in terms of nucleus hardness and endothelial cell loss was not statistically significant (p = 0.875). The correlation between anterior chamber depth (ACD) and ECL was also low (r = 0.131). At two months post-surgery, the difference in ACD and endothelial cell density between the two groups was not statistically significant (p = 0.309). There was a low correlation between intraocular pressure (IOP) and ECL (r = 0.21). Again, at two months postoperatively, no statistically significant difference was found in ECL between the two groups based on ACD (p = 0.871). The ECL rate after surgery in the group with shallow anterior chamber and high nucleus hardness was 7.79 ± 3.29%, while in the group with deeper anterior chamber and lower nucleus hardness it was 7.7 ± 3.75%, with statistical significance (p = 0.01). However, when comparing the two groups at the same time point, there was no significant difference in ECL rate (p = 0.935).Conclusion: When evaluating the factors affecting endothelial cell loss after surgery, no statistically significant differences were observed between the groups. These indicates that the combined use of cohesive and dispersive OVDs provides consistent endothelial cell protection in both Phaco and Phaco combined with anterior chamber angle opening in patients with primary angle-closure glaucoma and cataract.
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Keywords
Primary close angle glaucoma, phacoemulsification combined with goniosynechialysis, soft-shell technique.
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