The pattern of early corneal endothelial cell recovery following cataract surgery: cellular migration or enlargement?

Abstract

To evaluate whether cellular migration or enlargement is the main mechanism of initial endothelial cell recovery following cataract surgery. A prospective observational study, of 24 patients aged 50-80 years who were diagnosed with moderate cataract and received uncomplicated cataract surgery with a 2.75 mm temporal clear corneal incision, was performed in Seoul National University Bundang Hospital. Endothelial cell density (ECD) and area (ECA) were obtained in central and four paracentral (superior, inferior, nasal, and temporal) areas using non-contact specular microscopy. ECD, ECA, ECD% (ECD% = ECD in each area/the sum total of ECD in five areas), and the coefficient of variation of ECA (CV) in each location were investigated pre- and 1 day, 1 week, and 4 weeks postoperatively. ECD significantly decreased 1 day, 1 week, and 4 weeks postoperatively (p = 0.010, 0.015, and 0.003 respectively), and ECA increased (p = 0.008, 0.013, and 0.002 respectively) in only the temporal area. Postoperative ECD% decreased, and CV increased in only the temporal area significantly, when compared to preoperative values. There were no significant postoperative changes of ECD, ECA, ECD%, and CV in other areas. Postoperative changes of ECD, ECA, ECD%, and CV were limited to the temporal area adjacent to the primary corneal incision. Cellular enlargement, rather than migration, may have the major effect on early endothelial cell recovery after cataract surgery.