Anterior segment parameters using Pentacam and prediction of corneal endothelial cell loss after cataract surgery

Purpose

We evaluated various preoperative anterior segment parameters measured with a Pentacam rotating Scheimpflug camera and compared them with those of conventional methods. We also evaluated the effect of different parameters on corneal endothelial cells after cataract surgery.

Methods

Pentacam examination was performed in 88 eyes from 88 patients to evaluate central anterior chamber depth (ACD_pentacam), nuclear density (Densitometry_pentacam), anterior chamber volume (ACV), and lens thickness (LT_pentacam). We compared values of ACD_pentacam with those of ultrasound (ACD_sono) and also compared Densitometry_pentacam values with those of Lens Opacities Classification System (LOCS III) classification. We evaluated the effect of the following preoperative values measured with Pentacam on postoperative endothelial cell loss: pupil size measured both preoperatively and before capsulorrhexsis (Pupil_CCC), amount of viscoelastics, and LT measured by ultrasound (LT_sono).

Results

A significant concordance was found between the two grading methods of nuclear opacity: Densitometry_pentacam and LOCS III classification (τ_b = 0.414, p = 0.000). We also found a positive correlation between ACD_pentacam and ACD_sono (r = 0.823, p = 0.000) and between ACD_pentacam and ACV (r = 0.650, p = 0.000). There were significant differences between the results of LT_pentacam and LT_sono. The final regression model identified Densitometry_pentacam, viscoelastics and Pupil_CCC as independent predictors of decreased postoperative corneal endothelial cell density (CD) at postoperative day 3, and Densitometry_pentacam, viscoelastics, and ACV as independent predictors of decreased CD two months postoperatively (p<0.05).

Conclusions

Good agreement was found between all results obtained with the Pentacam and conventional methods except LT. Analyzing anterior chamber parameters preoperatively using Pentacam could be helpful to predict postoperative endothelial cell loss.