J Korean Ophthalmol Soc > Volume 56(4); 2015 > Article
Journal of the Korean Ophthalmological Society 2015;56(4):521-531.
DOI: https://doi.org/10.3341/jkos.2015.56.4.521    Published online April 15, 2015.
Protective Effect of Preoperative Intraocular Pressure Reduction on Corneal Endothelium in Cataract Surgery.
Yong Sun Ahn, Yang Kyung Cho
Department of Ophthalmology and Visual Science, The Catholic University of Korea College of Medicine, Seoul, Korea. yangkyeung@hanmail.net
백내장 수술 전 안압 하강의 각막 내피세포 보호 효과
안용선⋅조양경
가톨릭대학교 의과대학 안과 및 시과학교실
Abstract
PURPOSE
To evaluate whether intraocular pressure reduction by intravenous injection of mannitol before phacoemulsification-cataract surgery can have a protective effect on corneal endothelium. METHODS: Patients undergoing sequential bilateral cataract surgery were divided into 2 groups, 36 eyes with anterior chamber depth (ACD) < 2.50 mm (group A) and 44 eyes with ACD > or = 2.50 mm (group B). In each group, preoperative intravenous injection of mannitol was performed in 1 randomly selected eye of the patient. The specular microscopic examination including cell density (ECD), coefficient of variation (CV), hexagonality (HA) of corneal endothelium, and corneal thickness was performed on postoperative 1 day, 2 weeks, and 5 weeks. In each group, the parameters were compared between the eyes with mannitolization and the contralateral eyes without mannitolization. RESULTS: In group A, eyes with preoperative mannitolization showed significantly higher ECD at postoperative 1 day and 5 weeks and showed a significantly thinner cornea at postoperative 1 day than those without mannitolization (all p < 0.05). However, in group B, there was no significant difference of ECD, CV, HA, and corneal thickness between the eyes with and without mannitolization. CONCLUSIONS: Preoperative intraocular pressure reduction by mannitolization before phacoemulsification can protect the corneal endothelial cells and recover the early postoperative period visual acuity in eyes with shallow anterior chamber.
Key Words: Corneal endothelium;Mannitol;Microphthalmos;Phacoemulsification;Shallow anterior chamber


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