Núria Soler1, Pere Romero-Aroca2, Oscar Gris2, Jordi Camps2, Joan Fernandez-Ballart2. 1. From the Department of Ophthalmology (Soler, Romero-Aroca), the Unitat de Recerca Biomèdica (Camps), Hospital Universitari Sant Joan de Reus, and Preventive Medicine and Public Health (Fernandez-Ballart), Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Reus, Catalonia, Instituto de Microcirugia Ocular (Gris), Universitat Autònoma de Barcelona, Barcelona, and CIBER Fisiopatología de la Obesidad y Nutrición (Fernandez-Ballart), Instituto Carlos III, Spanish Government, Madrid, Spain. Electronic address: nsolerl@gmail.com. 2. From the Department of Ophthalmology (Soler, Romero-Aroca), the Unitat de Recerca Biomèdica (Camps), Hospital Universitari Sant Joan de Reus, and Preventive Medicine and Public Health (Fernandez-Ballart), Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Reus, Catalonia, Instituto de Microcirugia Ocular (Gris), Universitat Autònoma de Barcelona, Barcelona, and CIBER Fisiopatología de la Obesidad y Nutrición (Fernandez-Ballart), Instituto Carlos III, Spanish Government, Madrid, Spain.
Abstract
PURPOSE: To determine whether chronic obstructive pulmonary disease (COPD) is a risk factor for a reduced corneal endothelium functional reserve after cataract surgery. SETTING: Department of Ophthalmology, Hospital Universitari Sant Joan, Reus, Spain. DESIGN: Prospective clinical observational cohort study. METHODS: Patients were assigned to 1 of the following 3 groups: mild-to-moderate COPD, severe-to-very severe COPD, and without COPD (control). Before and 3 months after phacoemulsification, specular microscopy was used to evaluate the number and morphology of endothelial cells and the central corneal thickness (CCT) was measured to evaluate corneal decompensation. RESULTS: Preoperative results were recorded for 165 eyes. The mild-to-moderate COPD group comprised 67 eyes; the severe-to-very severe COPD group, 40 eyes; and the control group, 58 eyes. Cataract surgery was performed in 112 eyes. Significant differences in nearly all preoperative and 3-month postoperative corneal endothelial parameters were observed between the COPD groups and the control group, the former having a lower cell density and percentage of hexagonal cells and a higher coefficient of variance of the mean cell area. Two weeks postoperatively, the percentage of mild central corneal edema was 0%, 36%, and 31% in the control group, mild-to-moderate COPD group, and severe-to-very severe COPD group, respectively. There was no significant difference in the preoperative or 3-month postoperative mean CCT between the groups. CONCLUSION: Chronic obstructive pulmonary disease reduced endothelial functional reserve and increased corneal endothelial vulnerability to intraocular surgical stress. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.
PURPOSE: To determine whether chronic obstructive pulmonary disease (COPD) is a risk factor for a reduced corneal endothelium functional reserve after cataract surgery. SETTING: Department of Ophthalmology, Hospital Universitari Sant Joan, Reus, Spain. DESIGN: Prospective clinical observational cohort study. METHODS:Patients were assigned to 1 of the following 3 groups: mild-to-moderate COPD, severe-to-very severe COPD, and without COPD (control). Before and 3 months after phacoemulsification, specular microscopy was used to evaluate the number and morphology of endothelial cells and the central corneal thickness (CCT) was measured to evaluate corneal decompensation. RESULTS: Preoperative results were recorded for 165 eyes. The mild-to-moderate COPD group comprised 67 eyes; the severe-to-very severe COPD group, 40 eyes; and the control group, 58 eyes. Cataract surgery was performed in 112 eyes. Significant differences in nearly all preoperative and 3-month postoperative corneal endothelial parameters were observed between the COPD groups and the control group, the former having a lower cell density and percentage of hexagonal cells and a higher coefficient of variance of the mean cell area. Two weeks postoperatively, the percentage of mild central corneal edema was 0%, 36%, and 31% in the control group, mild-to-moderate COPD group, and severe-to-very severe COPD group, respectively. There was no significant difference in the preoperative or 3-month postoperative mean CCT between the groups. CONCLUSION:Chronic obstructive pulmonary disease reduced endothelial functional reserve and increased corneal endothelial vulnerability to intraocular surgical stress. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.