J Korean Ophthalmol Soc.  2017 Nov;58(11):1215-1224. 10.3341/jkos.2017.58.11.1215.

Change of Corneal Epithelial and Stromal Thickness after Cataract Surgery through Scleral Tunnel Incision

• Kim BJ
• Lee JH
• Kim SW

• KMID: 2395862
• DOI: http://doi.org/10.3341/jkos.2017.58.11.1215

Abstract

PURPOSE
To compare preoperative and postoperative thickness and to investigate the difference in the thickness change of corneal epithelium and stroma after cataract surgery through scleral tunnel incision.
METHODS
Forty eyes of forty patients who were 40 years old or older and underwent small-incision superior scleral tunnel cataract surgery with phacoemulsification were included. Using the RTVue instrument (Optovue Inc., Fremont, CA, USA), corneal epithelial (ET) and stromal thicknesses (ST) of all subjects were measured preoperatively and at 3 days, 1 week, and 1 month postoperatively. Thicknesses were classified into 3 zones according to the distance from the vertex: central zone (within 2 mm), paracentral zone (2-5 mm diameter) and midperipheral zone (5-6 mm diameter).
RESULTS
Mean central ST was 486.68 ± 25.15 µm, 535.16 ± 48.13 µm, 515.98 ± 44.07 µm, and 502.28 ± 34.87 µm preoperatively, and at 3 days, 1 week, and 1 month postoperatively, respectively (p < 0.001 for all). ST showed significant thickening in all three zones from 3 days to 1 month postoperatively (p < 0.001 for all). Mean central, paracentral, and midperipheral ET was 52.13 ± 3.41 µm, 50.42 ± 2.97 µm, 49.12 ± 3.05 µm at preoperatively and 51.03 ± 3.63 µm, 48.96 ± 3.62 µm, 47.67 ± 3.81 µm at 1 month postoperatively, respectively (p = 0.061, 0.006, 0.001, respectively), while there were no signficant changes in all three zones at 3 and 7 days postoperatively. Changes in ET and ST were prominent at the superotemporal incision site.
CONCLUSIONS
After scleral tunnel cataract surgery, corneal edema was observed in the stroma immediately after surgery. There was no significant change at early times after surgery in the epithelium, and there was a decrease in the peripheral cornea at 1 month postoperatively. The change in ET was considered a compensatory change due to stromal edema and appeared between 1 week to 1 month postoperatively.

Keyword

Cataract surgery; Corneal epithelium; Corneal remodeling; Corneal stroma; Corneal thickness

MeSH Terms

Cataract*
Cornea
Corneal Edema
Corneal Stroma
Edema
Epithelium
Epithelium, Corneal
Humans
Phacoemulsification

Figure

• 

  Figure 1 Schematic diagram of the cornea showing position of surgeon and analyzed area by RTVue. This diagram shows position of surgeon, incision site and analyzed areas on the cornea.

• 

  Figure 2 Preoperative corneal thickness. The preoperative epithelial thickness was thinner in the superior than inferior, but stromal thickness was thicker in the superior than inferior. S = superior; N = nasal; T = temporal; I = inferior.

• 

  Figure 3 Postoperative changes of corneal thickness. (A) 3 days postoperative. (B) 1 week postoperative. (C) 1 month postoperative. *p < 0.05; **p < 0.01 in repeated measure analysis of variance (ANOVA) with post-hoc comparison compared to preoperative thickness. S = superior; N = nasal; T = temporal; I = inferior.

• 

  Figure 4 Epithelial thickness changes among nuclear grade groups. (A) Central. (B) Paracentral. (C) Midperiphery. (D) Topographic variability. Pre-op = preoperative.

• 

  Figure 5 Stromal thickness changes among nuclear grade groups. (A) Central. (B) Paracentral. (C) Midperiphery. (D) Topographic variability. Pre-op = preoperative.

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