The following is a summary of “Effect of irrigation and aspiration on the corneal endothelial cell density in patients undergoing Implantable Collamer Lens with a central hole implantation for myopia correction,” published in the February 2024 issue of Ophthalmology by Zhang et al.
In traditional methods, rinsing viscoelastic agents with a balanced salt solution (BSS) can lead to complications like residue, chamber instability, and TICL rotation, but using irrigation and aspiration (I/A) is effective in stabilizing the chamber, reducing post-op pressure, and minimizing fundus issues. However, the effect of I/A on corneal endothelial cells during ICL implantation remains understudied.
Researchers conducted a retrospective study to investigate the impact of I/A on corneal endothelial cells in patients undergoing myopia correction via implantation of an Implantable Collamer Lens with a central hole (V4c ICL).
They retrospectively selected 344 eyes from 172 patients who underwent V4c ICL implantation and I/A to remove the viscoelastic agent (between 2021 and 2022). Intraocular pressure (IOP) was measured at 1 h, 2 h, and 3 h post-surgery. Corneal endothelial cell density (ECD), coefficient of variation in cell size (CV), standard deviation of cell area (SD), and percentage of hexagonal cells (HEX) were assessed at 1 week postoperatively to analyze corneal endothelial cells. ECD and CV indicate morphological variation, while SD reflects the degree of polymorphism. Electronic medical records were utilized for data collection.
The results showed that all surgeries were completed without complications. Before surgery, the IOP averaged 16.50 ± 3.42 mmHg (range: 11.5–22.3 mmHg), which increased to 21.25 ± 5.61 mmHg (range: 9.5–34.8 mmHg), 19.85 ± 5.18 mmHg (range: 11.4–36.2 mmHg), and then stabilized at an average of 18.81 ± 4.57 mmHg (range: 10.1–38.8 mmHg) at 1 h, 2 h, and 3 h after surgery. The preoperative ECD was 3004 ± 295 cell/mm2, showing a marginal decrease of 1.17%, resulting in an average ECD value of 2969 ± 303 cell/mm2 one week after surgery (P=0.12). The preoperative CV was 31.10 ± 3.78%, and it experienced a slight reduction with an average CV value of 30.74 ± 3.77% one week after surgery (P=0.21). Preoperative SD was 104.76 ± 17.26, and it remained virtually unchanged with an average SD value of 104.85 ± 18.75 one week after surgery (P=0.95). The preoperative hexagonality (HEX) was calculated as 55.38 ± 8.94%, and it maintained its stability with an average HEX value of 55.45 ± 8.73% one week after surgery (P=0.92).
Investigators concluded that I/A showed a small decrease in ECD after surgery, but it remained within acceptable limits due to its benefits like chamber stability and less residue
Source: link.springer.com/article/10.1007/s10792-024-02968-3