Corneal Endothelial Cell Loss After Phacoemulsification Compared With Extracapsular Cataract Extraction

NCT ID: NCT03262285

Last Updated: 2021-01-27

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

70 participants

Study Classification

OBSERVATIONAL

Study Start Date

2018-07-01

Study Completion Date

2021-01-15

Brief Summary

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the investigators will compare between the endothelial cell loss after phacoemulsification and extracapsular cataract extraction in management of senile cataract

Detailed Description

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Age related cataract is believed to be the main cause of reversible blindness worldwide and in developing countries. Population-based studies have reported that cataract is responsible for 47.8% to 51% of all global blindness.

Several studies compared phacoemulsification and conventional extracapsular cataract extraction regarding several aspects such as postoperative inflammation and visual rehabilitation. studies proved that phacoemulsification has faster rehabilitation ,less astigmatism and better postoperative vision .However, Extracapsular cataract extraction is still the operation of choice in some cataract cases.

The normal corneal endothelium is a single layer of uniformly sized cells with a predominantly hexagonal shape. Adult density of approximately 2400 - 3200 cells/mm².The number of cells decreases at about 0.6% per year and neighbouring cells enlarge to fill the space as the cells cannot regenerate.The minimum cell density necessary for adequate function is in the range of 400 to 700 cells/mm2.

The effect of cataract surgery on corneal endothelium is an important factor that affects postoperative vision .However, it is accepted all over the world that there is definite loss of some endothelial cells with all techniques of cataract surgery. Previously, cataract surgery caused enormous loss of endothelial cells , but with enhancement of equipment and surgical techniques, cataract surgery today results in 6-14%loss of endothelial cells.

Specular microscopy is a noninvasive photographic technique that allows visualization and analysis of corneal endothelium. specular microscopy is used to show cell count and cell shape in the scanned area.

Conditions

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Senile Cataract

Study Design

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Observational Model Type

CASE_ONLY

Study Time Perspective

PROSPECTIVE

Study Groups

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phacoemulsification

patients undergoing phacoemulsification surgery for senile cataract

phacoemulsification

Intervention Type PROCEDURE

removal of cataract using ultrasound waves

extracapsular cataract extraction

patients undergoing extracapsular cataract extraction surgery for senile cataract

extracapsular cataract extraction

Intervention Type PROCEDURE

removal of cataract using surgical corneal incision

Interventions

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phacoemulsification

removal of cataract using ultrasound waves

Intervention Type PROCEDURE

extracapsular cataract extraction

removal of cataract using surgical corneal incision

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Cases of senile cataract of both sexes will be included in this study

Exclusion Criteria

* Corneal endothelial pathologies such as Fuch's dystrophy
* Complicated cataract
* Cataract with history of trauma
* Coexisting eye pathology
Minimum Eligible Age

60 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Assiut University

OTHER

Sponsor Role lead

Responsible Party

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Rawda Abdelnaser

resident

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ali Ryad, professor

Role: STUDY_CHAIR

Assiut University

Locations

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Assiut university

Asyut, , Egypt

Site Status

Countries

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Egypt

References

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Lundstrom M, Goh PP, Henry Y, Salowi MA, Barry P, Manning S, Rosen P, Stenevi U. The changing pattern of cataract surgery indications: a 5-year study of 2 cataract surgery databases. Ophthalmology. 2015 Jan;122(1):31-8. doi: 10.1016/j.ophtha.2014.07.047. Epub 2014 Sep 16.

Reference Type BACKGROUND
PMID: 25234011 (View on PubMed)

Bourne RR, Stevens GA, White RA, Smith JL, Flaxman SR, Price H, Jonas JB, Keeffe J, Leasher J, Naidoo K, Pesudovs K, Resnikoff S, Taylor HR; Vision Loss Expert Group. Causes of vision loss worldwide, 1990-2010: a systematic analysis. Lancet Glob Health. 2013 Dec;1(6):e339-49. doi: 10.1016/S2214-109X(13)70113-X. Epub 2013 Nov 11.

Reference Type BACKGROUND
PMID: 25104599 (View on PubMed)

Resnikoff S, Pascolini D, Etya'ale D, Kocur I, Pararajasegaram R, Pokharel GP, Mariotti SP. Global data on visual impairment in the year 2002. Bull World Health Organ. 2004 Nov;82(11):844-51. Epub 2004 Dec 14.

Reference Type BACKGROUND
PMID: 15640920 (View on PubMed)

Wang W, Yan W, Muller A, He M. A Global View on Output and Outcomes of Cataract Surgery With National Indices of Socioeconomic Development. Invest Ophthalmol Vis Sci. 2017 Jul 1;58(9):3669-3676. doi: 10.1167/iovs.17-21489.

Reference Type BACKGROUND
PMID: 28728174 (View on PubMed)

Gogate PM, Kulkarni SR, Krishnaiah S, Deshpande RD, Joshi SA, Palimkar A, Deshpande MD. Safety and efficacy of phacoemulsification compared with manual small-incision cataract surgery by a randomized controlled clinical trial: six-week results. Ophthalmology. 2005 May;112(5):869-74. doi: 10.1016/j.ophtha.2004.11.055.

Reference Type BACKGROUND
PMID: 15878068 (View on PubMed)

Bourne WM, Nelson LR, Hodge DO. Central corneal endothelial cell changes over a ten-year period. Invest Ophthalmol Vis Sci. 1997 Mar;38(3):779-82.

Reference Type BACKGROUND
PMID: 9071233 (View on PubMed)

Bourne RR, Minassian DC, Dart JK, Rosen P, Kaushal S, Wingate N. Effect of cataract surgery on the corneal endothelium: modern phacoemulsification compared with extracapsular cataract surgery. Ophthalmology. 2004 Apr;111(4):679-85. doi: 10.1016/j.ophtha.2003.07.015.

Reference Type BACKGROUND
PMID: 15051198 (View on PubMed)

Trnavec B, Cuvala J, Cernak A, Vodrazkova E. [Comparison of corneal endothelial cells after ECCE and phacoemulsification of the lens]. Cesk Slov Oftalmol. 1997 Aug;53(4):240-3. Slovak.

Reference Type BACKGROUND
PMID: 9377317 (View on PubMed)

Other Identifiers

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CECLPEECCE

Identifier Type: -

Identifier Source: org_study_id

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