Endothelial microscopy - Is it an obligatory examination prior to cataract surgery?
S. Lechner, F.Schweig, M. Gerdemann, N. Anders, Chr. Hartmann
Introduction: A reduced number of endothelial cells increases the risks of the decompensation of the cornea after cataract surgery. The question is, if it is possible to decide by slitlamp microscopy to what degree the number of endothelial cells is reduced, because a normal looking cornea can also shows reduced number of endothelial cells.
Material and methods: We compared the number of endothelial cells in a group of 500 patients by analysing the photoprints of the non contact specular microscope Robo Ca CONAN before and after cataract surgery In this group we found normal corneas and cornea guttata of all states as well.
Results: We could show, that corneas which had been diagnosed as cornea gutata by slitlamp microscopy let endothelial cell numbers of more than 2000 cells. The postoperative outcome of those corneas was normal. We also found normal looking corneas with endothelial cell counts of less than 1500.
Conclusion: Corneas that appeared to have normal endothelial composition can have numbers below the critical border of 1500 cells. Therefore they leed to decompensation after surgery. We therefore consider endothelial microscopy preoperatively to be a helpful diagnostic tool in preparation of cataract surgery.
Dept. of Ophthalmology, Charité, Campus Virchow-Klinikum, D-13353 Berlin