Effect of elevated irrigation bottle height during cataract surgery on corneal endothelial cells in porcine eyes

TY - JOUR

T1 - Effect of elevated irrigation bottle height during cataract surgery on corneal endothelial cells in porcine eyes

AU - Wenzel, Daniel A

AU - Schultheiss, Constanze

AU - Druchkiv, Vasyl

AU - Hellwinkel, Olaf J C

AU - Schultheiss, Maximilian

AU - Schultheiss, Maximilian

AU - Casagrande, Maria

AU - Steinhorst, Nils Alexander

N1 - © 2023. The Author(s).

PY - 2023/5/11

Y1 - 2023/5/11

N2 - BACKGROUND: Cataract surgery induces corneal endothelial cell loss (ECL). This study investigates the relationship between bottle height (BH) and ECL induced due to irrigation and aspiration (I/A) in cataract surgery and quantifies protective effects of intraoperatively used ophthalmic viscoelastic substances.METHODS: Intermittent I/A without phacoemulsification was performed in porcine eyes for 10 min with varying BHs of 100 cm (BH100), 125 cm (BH125), 150 cm (BH150) or no treatment (control, no I/A). Additionally, in one group a dispersive ophthalmic viscoelastic substance was injected into the anterior eye chamber before treatment with I/A at a BH of 150 cm (BH150 + V). After exposure of the corneal endothelium to I/A, the corneas were prepared to split corneal buttons on day 0 and cultivated for 15 days. Endothelial cell density (ECD) was analyzed blinded on days 1, 8 and 15.RESULTS: Relative ECL significantly correlated with irrigation BH (control (n = 13): -9.69 ± 6.03% (average ± standard deviation); BH100 (n = 12): -9.69 ± 4.81%-p = 1.000; BH125 (n = 14): -19.44 ± 7.30% - p < 0.001; BH150 (n = 13): -21.99 ± 6.70%-p < 0.001). I/A-induced ECL was significantly decreased by the injection of ophthalmic viscoelastic, as BH150 + V (n = 14; -10.92 ± 4.09%-p = 1.000) showed a cell loss comparable to the control group.CONCLUSIONS: ECL is altered by I/A BH and reduced when viscoelastic substances are used.

AB - BACKGROUND: Cataract surgery induces corneal endothelial cell loss (ECL). This study investigates the relationship between bottle height (BH) and ECL induced due to irrigation and aspiration (I/A) in cataract surgery and quantifies protective effects of intraoperatively used ophthalmic viscoelastic substances.METHODS: Intermittent I/A without phacoemulsification was performed in porcine eyes for 10 min with varying BHs of 100 cm (BH100), 125 cm (BH125), 150 cm (BH150) or no treatment (control, no I/A). Additionally, in one group a dispersive ophthalmic viscoelastic substance was injected into the anterior eye chamber before treatment with I/A at a BH of 150 cm (BH150 + V). After exposure of the corneal endothelium to I/A, the corneas were prepared to split corneal buttons on day 0 and cultivated for 15 days. Endothelial cell density (ECD) was analyzed blinded on days 1, 8 and 15.RESULTS: Relative ECL significantly correlated with irrigation BH (control (n = 13): -9.69 ± 6.03% (average ± standard deviation); BH100 (n = 12): -9.69 ± 4.81%-p = 1.000; BH125 (n = 14): -19.44 ± 7.30% - p < 0.001; BH150 (n = 13): -21.99 ± 6.70%-p < 0.001). I/A-induced ECL was significantly decreased by the injection of ophthalmic viscoelastic, as BH150 + V (n = 14; -10.92 ± 4.09%-p = 1.000) showed a cell loss comparable to the control group.CONCLUSIONS: ECL is altered by I/A BH and reduced when viscoelastic substances are used.

KW - Animals

KW - Swine

KW - Endothelial Cells

KW - Cataract Extraction

KW - Phacoemulsification

KW - Endothelium, Corneal

KW - Cataract

KW - Cell Count

U2 - 10.1186/s12886-023-02954-w

DO - 10.1186/s12886-023-02954-w

M3 - SCORING: Journal article

C2 - 37170242

VL - 23

JO - BMC OPHTHALMOL

JF - BMC OPHTHALMOL

SN - 1471-2415

IS - 1

M1 - 211

ER -