Chronic obstructive pulmonary disease a risk factor for corneal damage during cataract surgery

This prospective study found that patients with chronic obstructive pulmonary disease (COPD) may be more likely to suffer corneal endothelial damage during intraocular surgery. 

The authors used specular microscopy to evaluate corneal endothelial changes in 165 eyes with a range of COPD. 

They found that COPD adversely affected pre- and postoperative endothelial cell density, area and hexagonality. By three months postop, the endothelial cell parameters had deteriorated significantly more in eyes with COPD than in eyes without it. 

This study is limited by the lack of stratification by nuclear grading, ultrasound energy or intra-operative fluidics. Further, they do not show a difference in degree of change in endothelial parameters between the COPD and control groups. 

Still, this article does highlight evidence for the correlation of COPD with reduced endothelial function and promotes careful preoperative planning in these cases. They recommend preoperative specular microscopy to help determine the suitable surgical time and if endothelial protective maneuvers are required.