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.