Changes in central corneal thickness three months after cataract surgery using phacoemulsification

Abstract

Introduction: The cornea is the most powerful refractive surface of the eye with the central cornea being pivotal to the visual axis, and hence visual acuity. Phacoemulsification is a method of cataract surgery that emits both thermal and ultrasonic energy which affects the cornea. Our study is to establish changes to the central corneal thickness (CCT) three months after surgery.

Objective: To establish the changes in CCT three months following phacoemulsification and the factors that influence these changes.

Materials and Methods: The study was a prospective case series carried out at the Eagle Eye and Laser Centre in Lavington, Nairobi. The recruitment of patients into the study was for 6 months between 1st August 2018 and 31st January 2019, and this was followed by a 3-month follow-up period until 30th April 2019. Eyes of patients who underwent phacoemulsification surgery were included. Eyes with pre-existing pathology, intra-operative and post-operative complications, were excluded. The CCT was measured using a Tomey EM-3000, a non-contact specular microscope; axial length and anterior chamber depth were taken from biometry readings by ZeissIOLMasterâ. Phacoemulsification was carried out by two surgeons using the same Alcon Accurusä Phacoemulsifier.

Results: A total of 41 eyes of 33 patients were studied. There was an overall 6.2% decrease in CCT in our study, which showed that despite the endothelial injury expected during phacoemulsification, our study population experienced good healing of their corneas. Corneas of diabetic patients were found to be thicker both before and after surgery likely due to the metabolic changes caused by disease. Anterior chamber depth was found to be a statistically significant predictor of post- operative CCT.

Conclusions: Uncomplicated phacoemulsification surgery has minimal effect in eventual CCT.