Assessment of influencing factors of corneal edema after cataract surgery based on AS-OCT
Objective To classify corneal edema after phacoemulsification combined with intraocular lens implantation by anterior segment optical coherence tomography(AS-OCT),and to analyze the influencing factors of corneal edema.Methods The clinical data of 234 patients(234 eyes)who underwent phacoemulsification combined with intraocular lens implantation in Jingzhou Aier Eye Hospital from January 2022 to December 2023 were selected,according to whether corneal edema occurred,the patients were divided into edema group and non-edema group.The grading of corneal edema in all patients was counted,the changes of corneal thickness in patients with grade 0 to 4 corneal edema were compared,and the influencing factors of corneal edema after cataract surgery were analyzed.Results There was no corneal edema(grade 0)in 165 eyes of 234 eyes,accounting for 70.51％;corneal edema occurred in 69 eyes,accounting for 29.49％,of which 42,19,6 and 2 eyes were grade 1,grade 2,grade 3 and grade 4,accounting for 17.95％,8.12％,2.56％and 0.85％,respectively.There were statistically significant differences in postoperative corneal thickness,corneal thickness increase and corneal thickness increase ratio among patients with grade 0 to 4 corneal edema(P<0.05).Univariate analysis results showed that there were statistically significant differences between the two groups in age,accompanying diabetes mellitus,lens nucleus hardness Ⅳ to Ⅴ degree,anterior chamber depth(ACD)≤3.0 mm,intraoperative phacoemulsification accumulated energy complex parameter(AECP)≥60％,intraoperative occurrence descemet's membrane detachment(DMD)and surgical incision by forward(P<0.05).Multivariate binary Logistic regression analysis results showed that age≥72 years,accompanying diabetes mellitus,lens nucleus hardness Ⅳ to Ⅴ degree,ACD≤3.0 mm,intraoperative phacoemulsification AECP≥60％,intraoperative occurrence DMD and surgical incision by forward were risk factors for corneal edema after cataract surgery(P<0.05).Conclusion The application of AS-OCT in the quantitative grading of corneal edema after cataract surgery has certain value.Age≥72 years,accompanying diabetes mellitus,lens nucleus hardness Ⅳ to Ⅴ degree,ACD≤3.0 mm,intraoperative phacoemulsification AECP≥60％,intraoperative occurrence DMD and surgical incision by forward are risk factors for corneal edema after cataract surgery.
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