Evaluation Of The Corneal Changes In The Center And Near The Incision Before And After Phacoemulsification With Confocal Microscopy

Recently, technological advances led to the development of powerful clinical confocal microscope which allows observation of the living human eyes in situ at the cellular level. The confocal microscopy in vivo is an acceptable and reproducible method to detect the changes of corneal endothelium, stroma and sublayer thickenss. Phacoemulsification has a smaller incision, no stitch and less postoperative astigmatism, compared with extracapsular cataract extraction (ECCE). It hasn't reported that the observation of central and peripheral corneal changes after phacoemulsification with confocal microscope through focusing (CMTF) besides endothelium.The aim of this study was to investigate and evaluate the changes of the cornea in the center and incision area before and after phacoemulsification with CMTF, and to discuss the wound healing process.In this study , 60 eyes of 60 patients with senile cataract who underwent phacoemulsification from July 2004 to January 2005 were analyzed. All the patients were examined by CMTF before and 1 week, 2 week, 1 month, 2 month and 3month after the surgery. We recorded their uncorrected visual acuity, intraocular pressure, corneal thickness, corneal cell density of each layer, the changes of corneal cell morphology, etc. Results are as following:1. The density of endothelium, anterior and posterior stroma in the elder group is less than the youth group. There are no significant difference between two groups in corneal thickness and epithelial density.2. Preoperatively, corneal thickness and endothelial cell density in the superior cornea is more than in the central cornea.3. A positive correlation is found between the endothelial cell density and the corneal thickness in the superior and central cornea.4. For the central cornea and incision area, the corneal thickness of 1 and 2 weeks post-operation is significantly more than pre-operation. There is no difference between 1,2,3 month and pre-operation.5. There is no significant difference between post-operation and pre-operation in the cell density of anterior stroma. And the cell density of posterior stroma in the 1, 2, 3 month after phacoemulsification is less than the density before phacoemulsification.6. For the central cornea and incision area, the endothelial cell density post-operation is always less than pre-operation.7. The size of endothelium in the central cornea and incision area is getting more and more postoperatively. And there is a significant difference between 2 week, 1,2,3 month after phacoemulsification and before it.8. Coefficient of variation of cell area in the central cornea gets more during the first l-2week, and then it gets less in the next 2 more months. The percentage of hexagonal cells shows an opposite trend. Coefficient of variation of cell area around the incision gets more and more along 3 months, and the percentage of hexagonal cells also shows an opposite trend, it gets less in the 3 months.9. The endothelial loss and the expansion of the endothelial area in the incision area is always more than central cornea at any time after phacoemulsification.10. Activated-cells were seen in the posterior stroma of the central cornea and the incision area of the cornea. And the reflection intensity decreased with time.According to the results, the conclusions are as following:1. The density of endothelium, anterior and posterior stroma in the elder people is...