The association between postoperative corneal edema and phacoemulsification level

Aim: To evaluate the effect of phacoemulsification level on postoperative central corneal thickness (CCT) differences and to assess the effects of demographic characteristics, biometric values and surgical parameters of patients on postoperative corneal edema. Methods: This prospective study included 232 eyes of 232 patients who underwent phacoemulsification surgery. Biometric values, phacoemulsification time, phacoemulsification power and effective phacoemulsification time (EPT) were evaluated. CCT measurements were repeated at follow-ups on days 1, 7 and 30 after surgery. Phaco-chop technique was performed in all patients and phacoemulsification level changes that occurred during surgery were recorded. Patients were grouped as Group 1: >75% of lens nucleus emulsified in capsular bag; Group 2: >75% of lens nucleus emulsified in iris plane; and Group 3: >50% of lens nucleus emulsified in anterior chamber. Results: Increase in the mean CCT values on the first day (incCCT1) and at the first week after surgery were more pronounced in Group 3 as compared with both Groups 1 and 2 (p < 0.05 for all). In addition, incCCT1 was higher in Group 2 than Group 1 (p=0.040). In the final model of multiple linear regression (R=0.31), it was determined that EPT, aqueous depth (AD) and phacoemulsification level significantly affected incCCT1 (p range: <0.001 to 0.009). Conclusions: The present study showed that more anterior phacoemulsification levels than the capsular bag caused higher CCT increase postoperatively. In addition, AD, EPT and phacoemulsification level were found as the most significant factors that influence postoperative corneal edema.