Abstract
Purpose
To evaluate whether cellular migration or enlargement is the main mechanism of initial endothelial cell recovery following cataract surgery.
Methods
A prospective observational study, of 24 patients aged 50–80 years who were diagnosed with moderate cataract and received uncomplicated cataract surgery with a 2.75 mm temporal clear corneal incision, was performed in Seoul National University Bundang Hospital. Endothelial cell density (ECD) and area (ECA) were obtained in central and four paracentral (superior, inferior, nasal, and temporal) areas using non-contact specular microscopy. ECD, ECA, ECD% (ECD% = ECD in each area/the sum total of ECD in five areas), and the coefficient of variation of ECA (CV) in each location were investigated pre- and 1 day, 1 week, and 4 weeks postoperatively.
Results
ECD significantly decreased 1 day, 1 week, and 4 weeks postoperatively (p = 0.010, 0.015, and 0.003 respectively), and ECA increased (p = 0.008, 0.013, and 0.002 respectively) in only the temporal area. Postoperative ECD% decreased, and CV increased in only the temporal area significantly, when compared to preoperative values. There were no significant postoperative changes of ECD, ECA, ECD%, and CV in other areas.
Conclusions
Postoperative changes of ECD, ECA, ECD%, and CV were limited to the temporal area adjacent to the primary corneal incision. Cellular enlargement, rather than migration, may have the major effect on early endothelial cell recovery after cataract surgery.
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References
Vajpayee RB, Kumar A, Dada T, Titiyal JS, Sharma N, Dada VK (2000) Phaco-chop versus stop-and-chop nucleotomy for phacoemulsification. J Cataract Refract Surg 26:1638–1641
Liu Y, Zeng M, Liu X, Luo L, Yuan Z, Xia Y, Zeng Y (2007) Torsional mode versus conventional ultrasound mode phacoemulsification: randomized comparative clinical study. J Cataract Refract Surg 33:287–292
Zeng M, Liu X, Liu Y, Xia Y, Luo L, Yuan Z, Zeng Y (2008) Torsional ultrasound modality for hard nucleus phacoemulsification cataract extraction. Br J Ophthalmol 92:1092–1096
Storr-Paulsen A, Norregaard JC, Ahmed S, Storr-Paulsen T, Pedersen TH (2008) Endothelial cell damage after cataract surgery: divide-and-conquer versus phaco-chop technique. J Cataract Refract Surg 34:996–1000
Krachmer JH, Mannis MJ, Holland EJ (2010) Cornea. In: Nishida T, Saika S (eds) Cornea and sclera — anatomy and physiology, 3rd edn. Elsevier Mosby, Philadelphia, pp 4–24
Ichijima H, Petroll WM, Jester JV, Barry PA, Andrews PM, Dai M, Cavanagh HD (1993) In vivo confocal microscopic studies of endothelial wound healing in rabbit cornea. Cornea 12:369–378
Tuft SJ, Williams KA, Coster DJ (1986) Endothelial repair in the rat cornea. Invest Ophthalmol Vis Sci 27:1199–1204
Matsuda M, Sawa M, Edelhauser HF, Bartels SP, Neufeld AH, Kenyon KR (1985) Cellular migration and morphology in corneal endothelial wound repair. Invest Ophthalmol Vis Sci 26:443–449
Matsubara M, Tanishima T (1982) Wound-healing of the corneal endothelium in the monkey: a morphometric study. Jpn J Ophthalmol 26:264–273
Yamaguchi M, Ebihara N, Shima N, Kimoto M, Funaki T, Yokoo S, Murakami A, Yamagami S (2011) Adhesion, migration, and proliferation of cultured human corneal endothelial cells by laminin-5. Invest Ophthalmol Vis Sci 52:679–684
Nakahara M, Okumura N, Kay EP, Hagiya M, Imagawa K, Hosoda Y, Kinoshita S, Koizumi N (2013) Corneal endothelial expansion promoted by human bone marrow mesenchymal stem cell-derived conditioned medium. PLoS One 8, e69009
Patel SV, Bachman LA, Hann CR, Bahler CK, Fautsch MP (2009) Human corneal endothelial cell transplantation in a human ex vivo model. Invest Ophthalmol Vis Sci 50:2123–2131
Joko T, Shiraishi A, Akune Y, Tokumaru S, Kobayashi T, Miyata K, Ohashi Y (2013) Involvement of P38MAPK in human corneal endothelial cell migration induced by TGF-beta(2). Exp Eye Res 108:23–32
Hughes EH, Pretorius M, Eleftheriadis H, Liu CS (2007) Long-term recovery of the human corneal endothelium after toxic injury by benzalkonium chloride. Br J Ophthalmol 91:1460–1463
Schilling-Schon A, Pleyer U, Hartmann C, Rieck PW (2000) The role of endogenous growth factors to support corneal endothelial migration after wounding in vitro. Exp Eye Res 71:583–589
Regis-Pacheco LF, Binder PS (2014) What happens to the corneal transplant endothelium after penetrating keratoplasty? Cornea 33:587–596
Jacobi C, Zhivov A, Korbmacher J, Falke K, Guthoff R, Schlötzer-Schrehardt U, Cursiefen C, Kruse FE (2011) Evidence of endothelial cell migration after Descemet membrane endothelial keratoplasty. Am J Ophthalmol 152:537–542
Chylack LT Jr, Wolfe JK, Singer DM, Leske MC, Bullimore MA, Bailey IL, Friend J, McCarthy D, Wu SY (1993) The lens opacities classification system III. The Longitudinal Study of Cataract Study Group. Arch Ophthalmol 111:831–836
Joyce NC (2005) Cell cycle status in human corneal endothelium. Exp Eye Res 81:629–638
Bourne WM, McLaren JW (2004) Clinical responses of the corneal endothelium. Exp Eye Res 78:561–572
Dick HB, Kohnen T, Jacobi FK, Jacobi KW (1996) Long-term endothelial cell loss following phacoemulsification through a temporal clear corneal incision. J Cataract Refract Surg 22:63–71
Diaz-Valle D, del Castillo B, Sanchez JM, Castillo A, Sayagues O, Moriche M (1998) Endothelial damage with cataract surgery techniques. J Cataract Refract Surg 24:951–955
Walkow T, Anders N, Klebe S (2000) Endothelial cell loss after phacoemulsification: relation to preoperative and intraoperative parameters. J Cataract Refract Surg 26:727–732
Beltrame G, Salvetat ML, Driussi G, Chizzolini M (2002) Effect of incision size and site on corneal endothelial changes in cataract surgery. J Cataract Refract Surg 28:118–125
Inoue K, Tokuda Y, Inoue Y, Amano S, Oshika T, Inoue J (2002) Corneal endothelial cell morphology in patients undergoing cataract surgery. Cornea 21:360–363
Ravalico G, Botteri E, Baccara F (2003) Long-term endothelial changes after implantation of anterior chamber intraocular lenses in cataract surgery. J Cataract Refract Surg 29:1918–1923
Bourne RR, Minassian DC, Dart JK, Rosen P, Kaushal S, Wingate N (2004) Effect of cataract surgery on the corneal endothelium: modern phacoemulsification compared with extracapsular cataract surgery. Ophthalmology 111:679–685
Lee JS, Lee JE, Choi HY, Oum BS, Cho BM (2005) Corneal endothelial cell change after phacoemulsification relative to the severity of diabetic retinopathy. J Cataract Refract Surg 31:742–749
McCarey BE, Edelhauser HF, Lynn MJ (2008) Review of corneal endothelial specular microscopy for FDA clinical trials of refractive procedures, surgical devices and new intraocular drugs and solutions. Cornea 27:1–16
Gonen T, Sever O, Horozoglu F, Yasar M, Keskinbora KH (2012) Endothelial cell loss: biaxial small-incision torsional phacoemulsification versus biaxial small-incision longitudinal phacoemulsification. J Cataract Refract Surg 38:1918–1924
Vasavada AR, Vasavada V, Vasavada VA, Praveen MR, Johar SR, Gajjar D, Arora AI (2012) Comparison of the effect of torsional and microburst longitudinal ultrasound on clear corneal incisions during phacoemulsification. J Cataract Refract Surg 38:833–839
Assaf A, Roshdy MM (2013) Comparative analysis of corneal morphological changes after transversal and torsional phacoemulsification through 2.2 mm corneal incision. Clin Ophthalmol 7:55–61
Schultz RO, Glasser DB, Matsuda M, Yee RW, Edelhauser HF (1986) Response of the corneal endothelium to cataract surgery. Arch Ophthalmol 104:1164–1169
Werblin TP (1993) Long-term endothelial cell loss following phacoemulsification: model for evaluating endothelial damage after intraocular surgery. Refract Corneal Surg 9:29–35
Dick B, Kohnen T, Jacobi KW (1995) Endothelial cell loss after phacoemulsification and 3.5 vs. 5 mm corneal tunnel incision. Ophthalmologe 92:476–483
Mathys KC, Cohen KL, Armstrong BD (2007) Determining factors for corneal endothelial cell loss by using bimanual microincision phacoemulsification and power modulation. Cornea 26:1049–1055
Ling T, Vannas A, Holden B (1988) Long-term changes in corneal endothelial morphology following wounding in the cat. Invest Ophthalmol Vis Sci 29:1407–1412
Huang P, Nelson L, Bourne W (1989) The morphology and function of healing cat corneal endothelium. Invest Ophthalmol Vis Sci 30:1794–1801
Treffers WF (1982) Human corneal endothelial wound repair. In vitro and in vivo. Ophthalmology 89:605–613
Rieck PW, Cholidis S, Hartmann C (2001) Intracellular signaling pathway of FGF-2-modulated corneal endothelial cell migration during wound healing in vitro. Exp Eye Res 73:639–650
Lee JG, Kay EP (2006) FGF-2-induced wound healing in corneal endothelial cells requires Cdc42 activation and Rho inactivation through the phosphatidylinositol 3-kinase pathway. Invest Ophthalmol Vis Sci 47:1376–1386
He Z, Campolmi N, Gain P, Ha Thi BM, Dumollard JM, Duband S, Peoc’h M, Piselli S, Garraud O, Thuret G (2012) Revisited microanatomy of the corneal endothelial periphery: new evidence for continuous centripetal migration of endothelial cells in humans. Stem Cells 30:2523–2534
Price N, Jacobs P, Cheng H (1982) Rate of endothelial cell loss in the early postoperative period after cataract surgery. Br J Ophthalmol 66:709–713
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Kim, DH., Wee, W.R. & Hyon, J.Y. The pattern of early corneal endothelial cell recovery following cataract surgery: cellular migration or enlargement?. Graefes Arch Clin Exp Ophthalmol 253, 2211–2216 (2015). https://doi.org/10.1007/s00417-015-3100-5
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DOI: https://doi.org/10.1007/s00417-015-3100-5