Protective Effect of Preoperative Intraocular Pressure Reduction on Corneal Endothelium in Cataract Surgery

ABSTRACT

PURPOSE: To evaluate whether intraocular pressure reduction by intravenous injection of mannitol before phacoemulsification-cataract surgery can have a protective effect on corneal endothelium. METHODS: Patients undergoing sequential bilateral cataract surgery were divided into 2 groups, 36 eyes with anterior chamber depth (ACD) or = 2.50 mm (group B). In each group, preoperative intravenous injection of mannitol was performed in 1 randomly selected eye of the patient. The specular microscopic examination including cell density (ECD), coefficient of variation (CV), hexagonality (HA) of corneal endothelium, and corneal thickness was performed on postoperative 1 day, 2 weeks, and 5 weeks. In each group, the parameters were compared between the eyes with mannitolization and the contralateral eyes without mannitolization. RESULTS: In group A, eyes with preoperative mannitolization showed significantly higher ECD at postoperative 1 day and 5 weeks and showed a significantly thinner cornea at postoperative 1 day than those without mannitolization (all p < 0.05). However, in group B, there was no significant difference of ECD, CV, HA, and corneal thickness between the eyes with and without mannitolization. CONCLUSIONS: Preoperative intraocular pressure reduction by mannitolization before phacoemulsification can protect the corneal endothelial cells and recover the early postoperative period visual acuity in eyes with shallow anterior chamber.