The effects of blunt trauma and cataract surgery on corneal endothelial cell density

Middle East Afr J Ophthalmol. 2010 Oct;17(4):354-8. doi: 10.4103/0974-9233.71604.

Abstract

Purpose: This study was designed to investigate the effects of trauma and cataract surgery on corneal endothelial cell density (ECD) in patients with a traumatic cataract due to blunt trauma without globe laceration.

Materials and methods: In this prospective study, 31 subjects with traumatic cataract (traumatic cataract group) and 30 subjects with a senile cataract (control group) were enrolled. The subjects with traumatic cataract were subdivided into two groups: uncomplicated surgery subgroup (n = 19) in which subjects underwent standard phacoemulsification with intraocular lens implantation and complicated surgery subgroup (n = 12) in which subjects underwent cataract surgery other than standard phacoemulsification. The ECD of the traumatic cataract group and the control group was compared preoperatively and at 3 months or later postoperatively. A P value less than 0.05 was considered statistically significant.

Results: The ECD in the eyes with traumatic cataract was 13.1% lower than that for healthy eyes preoperatively (P = 0.043). Postsurgical ECD decreased by 16.7% in complicated surgery subgroup and 11.9% in uncomplicated surgery subgroup (P = 0.049) after 3 months postoperatively. The ECD decreased by 10.8% in the control group (P = 0.489).

Conclusions: Patients with cataracts due to blunt trauma had a decreased endothelial cell count, which was significantly aggravated by cataract surgery. The loss of corneal endothelium cells due to surgery depends on the surgical approach.

Keywords: Confocal Microscopy; Corneal Endothelium; Phacoemulsification; Senile Cataract; Traumatic Cataract.