Expression of Na+/K+ ATPase and changes of corneal endothelium cell density after phacoemulsification with hypothermic perfusion

Abstract

Background: Intraocular hypothermic perfusion can be used as an alternative to reduce corneal endothelial cell damage in phacoemulsification procedures. This study aimed to analyze the effect of hypothermic intraocular perfusion on cell density and expression of the Na+/K+-ATPase on corneal endothelial cells after exposure to ultrasonic phacoemulsification energy. Methods: Sixteen New Zealand white rabbits (n=16 eyes) were randomly divided into two groups and exposed to phacoemulsification ultrasonic energy. The control group received room-temperature Intraocular Balanced Salt Solution (BSS) hyperthermic perfusion (24oC) and the treatment group received low-temperature intraocular BSS hypothermic perfusion (4oC). Corneal endothelial cell density (ECD) was measured before and 1 day after surgery using a specular microscope. On the first postoperative day, the expression of Na+/K+ATPase was examined using immunohistochemical antibody staining. Data were analyzed using SPSS version 26 for Windows. Results: There was no statistically significant difference in the expression of corneal endothelial Na+/K+-ATPase between the control and treatment groups (p=0.053). There was no significant difference in corneal endothelial cell density changes between the control and treatment groups (p=0.115). There was no correlation between changes in cell density and corneal endothelial Na+/K+ATPase expression in the control and treatment groups (p=0.216). Conclusion: The effect of intraocular hypothermic perfusion on phacoemulsification procedures remains controversial. Endothelial cell density decreased in hypothermic perfusion after phacoemulsification and Na+/K+ATPase expression was not significantly affected by hypothermic perfusion.