Anterior capsule sparing parsplana lensectomy in cataract with severely compromised corneal endothelium

Abstract

To evaluate the results of parsplana lensectomy in the management of cataract with severely compromised or abnormal corneal endothelium. Retrospective interventional case study comprised 22 patients (9 women, 13 men; 22 eyes) with severely abnormal corneal endothelium ut still had transparent cornea. Of which 14 had history of penetrating keratoplasty, 6 had history of trabeculectomy and 2 were diagnosed with Fuch’s endothelial dystrophy. Postoperative est corrected visual acuity (BCVA), mean density of corneal endothelial cell and other complications were analyzed. Mean follow-up period was 17.2 months (ranging from 6 to 31 months). Postoperative BCVA were found to be 6/60 or below in 2 patients, 6/60-6/18 in 7 patients and 6/18-6/12 in 7 patients and 6/12 or better in 6 patients. BCVA improved in all patients after surgery, except in one patient with Fuch’s endothelial dystrophy BCVA turned worse again about five months after surgery and eventually patient developed bullous keratopathy. The mean density of corneal endothelial cells was 1018± 84/ mm (range 844/ mm to 1176/ mm) before operation and 981±93/ mm (range 853 to 1211/ mm) after operation. No significant difference in the density of corneal endothelial cells was found among the patients before and after operation (P=0.43).Pars plana lensectomy is able to decrease surgically-induced corneal endothelial damage and is safe in the management of cataract with severely compromised corneal endothelium.