Cataract surgery alone should be performed first in low ECD eyes

A study featured in the Journal of Cataract and Refractive Surgery found that eyes with low endothelial cell density (ECD) experienced comparable corneal endothelial damage to that of healthy eyes post-cataract surgery, indicating that only cataract surgery should be considered as the initial treatment.

Dr Ken Hayashi et al., Hayashi Eye Hospital, Fukuoka, Japan, conducted a case control study on 100 eyes undergoing cataract surgery. Fifty eyes were placed into a low-density group and the remaining 50 comprised of the control group. Of the eyes in the low-density group, 39 had non-progressive endothelial pathology and 11 had Fuchs dystrophy.

Cataract surgery was performed on both groups and the ECD and central corneal thickness (CCT) were measured preoperatively and 1 and 3 months postoperatively. The increase in CCT and the percentage of cell loss were compared.

Overall, the mean ECD was significantly lower and CCT was higher in the low-density group compared to the control group. There was no significant difference in cell loss percentage was reported between the groups at 1 or 3 months postoperatively.

Based on the results the study advises that cataract surgery should be performed first without corneal transplantation.