December 2019

ASCRS NEWS

Eyeworld Journal Club
Effect of hypothermic perfusion on phacoemulsification in eyes with hard nuclear cataract: a randomised trial


by Wenjuan Wan, MD, Lu Jiang, Yan Ji, MD, Yan Xun, Liang Xiong, MD, Yongguo Xiang, Ruonan Li, Zhouyu Li, Xiaoqin Wang, MD, Jay M. Stewart, MD, Ke Hu, MD, PhD

• Purpose: To evaluate the effectiveness and safety of hypothermic perfusion in the phacoemulsification of hard nuclear cataract.
• Setting: In a tertiary center of ophthalmology in China.
• Design: An animal study and a prospective randomised clinical trial.
• Methods: A total of 40 rabbits and 80 patients with hard nuclear cataract underwent phacoemulsification with perfusion temperatures at 4°C or 24°C. Anterior segment optical coherence tomography (OCT), corneal endothelial cell count and cornea sections were observed before rabbits’ operation and on the 1st and 7th day postoperatively. Anterior segment OCT, corneal endothelial cell count and anterior chamber (AC) inflammation were observed before patients’ operation and on the 1st, 7th and 30th day postoperatively.

• Results: In animal models, the central cornea thickness of the 4°C group (370.4±45.5μm) was thinner than that of the 24°C group (496.7±121.5μm) on the first day postoperatively (P<0.001). The AC inflammation reaction grade of 4°C group (1.1±0.9) was lower than that of 24°C group (2.2±0.8, P=0.0333). In clinical trials, the central and incisional cornea thickness in 4°C group (600.7±51.8μm and 859.2±177.8μm) were thinner than those in 24°C group (655.3±85.0μm and 955.9±196.7μm, P<0.001). The endothelial cell density (P=0.036) and hexagonality (P=0.001) were higher in 4°C group. The AC inflammation reaction grade of 4°C group (0.6±0.6) was lower than that of 24 °C group (1.3±1.0, P=0.004) on the first day postoperatively.
• Conclusions: Hypothermic perfusion in phacoemulsification of hard nuclear cataract is safe and it can effectively protect corneal endothelium, decrease corneal edema and reduce AC inflammation in the early postoperative stage.

Effect of hypothermic perfusion on phacoemulsification in eyes with hard nuclear cataract: a randomised trial Effect of hypothermic perfusion on phacoemulsification in eyes with hard nuclear cataract: a randomised trial
Ophthalmology News - EyeWorld Magazine
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2019-12-02T12:54:17Z
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