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Postoperative Corneal Edema After Phacoemulsification

Aim: To determine the effect of nuclear opalescence (NO) on intraoperative parameters during phacoemulsification using the WhiteStar Signature® PRO and to show the impact of preoperative and intraoperative parameters on postoperative corneal edema.Methods: This prospective study included 267 patients selected to undergo phacoemulsification using the WhiteStar Signature® PRO system at the Department of Ophthalmology of the General Hospital “Dr Josip Benčević”, Slavonski Brod, Croatia. NO was graded using the Lens Opacities Classification System III. Preoperative parameters were age, sex, NO and preoperative central corneal thickness. Intraoperative parameters of phacoemulsification included in the study were ultrasound time (UST), phaco time using Ellips FX technology (EFX) and average phaco power (AVG). Patients were followed up on postoperative days 1 and 7 and after two months. The state of the cornea was noted in each follow-up.Results: There was a statistically significant increase of intraoperative parameters with NO. Postoperative corneal edema depended on all measured intraoperative parameters (UST, EFX and AVG, all p < .001), patient’s age (p < .05) and NO (p < .001) on postoperative day 1, while on postoperative day 7, it depended on UST (p = .011) EFX (p = .012) and NO (p < .05).Conclusion: Older patients, higher grade of NO and amount of energy consumed during phacoemulsification using the WhiteStar Signature® PRO are predictive factors for severity of transient corneal edema. We found this information important for better preoperative planning of phacoemulsification, as well as for better postoperative results.