Cataract surgery alone should be performed first in low ECD eyes

July 14, 2011

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.

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.