Beyoglu eye journal · 2026
Endothelial Safety After Phacoemulsification in Patients with Fuchs Dystrophy: Short Term Outcomes and Predictors of Corneal Edema.
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Yüksel Bora, Açar Nurullah Berk, Kusbeci Tuncay, Icel Erel
Аннотация
OBJECTIVES: To compare the clinical outcomes of phacoemulsification combined with intraocular lens implantation in patients with Fuchs endothelial corneal dystrophy (FECD) and individuals with healthy corneas.
METHODS: This retrospective study included eyes that underwent phacoemulsification and intraocular lens (IOL) implantation between January 2021 and September 2022. Phacoemulsification was performed using a contemporary oscillatory ultrasound mode; device-logged energy and fluidics metrics were recorded. Best corrected visual acuity (BCVA) and specular microscopy (CEM-530™; Nidek) were evaluated preoperatively and at postoperative week 1, month 1, and month 3. Endothelial cell density (ECD) and central corneal thickness (CCT) were recorded. The primary outcome measures were postoperative BCVA, ECD, and CCT changes. The study included 32 eyes with FECD and 29 control eyes with healthy corneas.
RESULTS: In both groups, mean BCVA improved significantly from 0.7 LogMAR preoperatively to 0.15 LogMAR at 1 month postoperatively (p=0.000). The endothelial cell loss at 3 months was significantly higher in the FECD group compared to controls (20.9% vs. 17.9%, p=0.022). Baseline ECD was 2065.5 cells/mm2 in the FECD group and 2289.4 cells/mm2 in the control group, decreasing to 1633.1 and 1878.9 cells/mm2, respectively, at 3 months. CCT increased from 564.5 µm to 584.1 µm in the FECD group (p=0.006), and from 550.5 µm to 557.7 µm in the control group (p=0.124). No cases of postoperative corneal decompensation were observed.
CONCLUSION: Phacoemulsification yielded meaningful visual improvement in FECD eyes without early corneal decompensation. Endothelial loss as higher and CCT recovery slower than in controls, supporting energy-minimizing techniques and closer early follow-up in FECD.
METHODS: This retrospective study included eyes that underwent phacoemulsification and intraocular lens (IOL) implantation between January 2021 and September 2022. Phacoemulsification was performed using a contemporary oscillatory ultrasound mode; device-logged energy and fluidics metrics were recorded. Best corrected visual acuity (BCVA) and specular microscopy (CEM-530™; Nidek) were evaluated preoperatively and at postoperative week 1, month 1, and month 3. Endothelial cell density (ECD) and central corneal thickness (CCT) were recorded. The primary outcome measures were postoperative BCVA, ECD, and CCT changes. The study included 32 eyes with FECD and 29 control eyes with healthy corneas.
RESULTS: In both groups, mean BCVA improved significantly from 0.7 LogMAR preoperatively to 0.15 LogMAR at 1 month postoperatively (p=0.000). The endothelial cell loss at 3 months was significantly higher in the FECD group compared to controls (20.9% vs. 17.9%, p=0.022). Baseline ECD was 2065.5 cells/mm2 in the FECD group and 2289.4 cells/mm2 in the control group, decreasing to 1633.1 and 1878.9 cells/mm2, respectively, at 3 months. CCT increased from 564.5 µm to 584.1 µm in the FECD group (p=0.006), and from 550.5 µm to 557.7 µm in the control group (p=0.124). No cases of postoperative corneal decompensation were observed.
CONCLUSION: Phacoemulsification yielded meaningful visual improvement in FECD eyes without early corneal decompensation. Endothelial loss as higher and CCT recovery slower than in controls, supporting energy-minimizing techniques and closer early follow-up in FECD.