Effect of Anterior Chamber Depth on Corneal Endothelial Change After Phacoemulsification

PURPOSE: To evaluate the effects of preoperative and postoperative parameters, particularly anterior chamber depth, on corneal endothelial cell loss during cataract surgery. METHODS: Eighty-two eyes of 82 patients who underwent cataract surgery by the same surgeon using the same technique were selected for the present study. Various preoperative and postoperative parameters including age, anterior chamber depth, duration and power of phacoemulsification, preoperative endothelial cell density, coefficient of variation, hexagonality, and grade of nucleosclerosis were evaluated. Endothelial cell densities were recorded preoperatively and at two months postoperatively using a noncontact specular microscope. RESULTS: After two months, the mean central endothelial cell loss in all eyes was 8.77%. Among the pre- and post-operative parameters, patient' age, anterior chamber depth, duration, power, and energy of phacoemulsification and grade of nucleosclerosis showed significant correlation with endothelial cell loss. Stepwise multiple linear regression analysis identified age, nucleosclerosis, anterior chamber depth, and phacoemulsification time as independent predictors for endothelial cell loss. CONCLUSIONS: The risk of endothelial cell loss increased with increases in patient' age, nucleosclerosis, and phacoemulsification time. However, eyes with a deep anterior chamber showed a significantly lower risk of endothelial cell loss.

Total Hip Replacement in Unreduced Hip Dislocation / 대한정형외과학회잡지

Total hip arthroplasty in patients with chronically dislocated hips poses many challenging technical problems. Abnormal relationship of bones and soft tissues occurs in chronic complete dislocation of the hip (grade IV, Crowe's classification). Problems in placing the acetabular component in the true acetabulum include, first how to cover the acetabular component sufficiently, second how to fix it securely and last how to avoid excessive stretching of the neurovascular structures such as the sciatic nerve. The authors have introduced a technique of one stage distal femoral shortening in order to avoid excessive stretching of the neurovascular structures. From December 1988 to May 1996, the total hip arthroplasties combined with one stage distal femoral shortening were carried out in chronic complete dislocation of 44 hips (grade IV, Crowe's classification) and followed-up more than two years. This method has several advantages: It preserves wide and healthy proximal metaphysis of the femur, does not need greater trochanteric osteotomy, and provides many chances to choose the appropriate stem size and shape, especially in cementless total hip arthroplasty.