ISSN: 1300-0365
Dil: Türkçe
|
|
|
|
ORIGINAL RESEARCH ARTICLES |
Intraoperative Ascorbic Acid Against Free Radical-induced Corneal Endothelial Damage In Phacoemulsification Surgery
Dr. Süleyman GENCER,a Dr. C. Banu COŞAR,a Dr. Suphi ACARa
a2. Göz Kliniği, Haydarpaşa Numune Eğitim ve Araştırma Hastanesi, İSTANBUL
Objective: To investigate the protective role of intraoperative ascorbic acid against free radical-induced corneal endothelial damage in phacoemulsification surgery.
Material and Methods: Patients who underwent phacoemulsification surgery in our clinic between December 2003 and June 2004 were randomly assigned into control and study (ascorbic acid) groups. All of the eyes had 4mm oblique clear corneal incision phacoemulsification surgery with implantation of foldable acrylic intraocular lens. In the operations of 28 patients (37 eyes) in the control group, balanced electrolyte solution(BES) was used as the irrigating solution whereas in the ascorbic acid group which consisted of 28 patients (35 eyes), the irrigating solution was BES with 0.002 M ascorbic acid. Total phacoemulsification times were recorded at the end of each surgery. Patients were examined preoperatively and postoperatively at week 1, month 1 and month 3. Endothelial cell densities and central corneal thickness measurements were recorded at each visit.
Results: There was no statistically significant differences between the two groups in terms of endothelial cell density, central corneal thickness, surgically induced endothelial cell loss and change in central corneal thickness(p>0.05). Endothelial cell density was observed to decrease progressively in both groups in 3 months follow up, whereas central corneal thickness significantly (p<0.001) increased at the 1st week and then regressed to preoperative levels at month 1 and month 3 visits. In both groups, the total phacoemulsification time was not correlated with change in central corneal thickness at the 1st week and surgically induced endothelial cell loss at 1st week and 1st month. However it was observed that the the total phacoemulsification time was correlated with surgically induced endothelial cell loss at the 3rd month postoperatively in both control and ascorbic acid groups (r=-0.415, p=0.025 and r=-0.409, p=0.038 respectively.)
Conclusion: In this study, there was no statistically significant difference between usage of of BES with 0.002 M ascorbic acid and BES alone as the irrigating solution during phacoemulsification in terms of corneal endothelial cell protection in 3 months follow up. We did not observe any intraoperative or postoperative complications attributable to ascorbic acid in any of the cases.Keywords: Ascorbic acid, phacoemulsification, corneal endothelium, free radicalsTurkiye Klinikleri J Ophthalmol 2006, 15:45-53
|
|
|
|
|
