scholarly journals Femtosecond laser semi-assisted Descemet stripping endothelial keratoplasty: 2-year outcomes of endothelial cell loss and graft survival

2021 ◽  
Author(s):  
Ting Wang ◽  
Peiyan Shi ◽  
Fengjie Li ◽  
Hua Gao ◽  
Suxia Li ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Endothelial Cell ◽  
Endothelial Dysfunction ◽  
Femtosecond Laser ◽  
Graft Survival ◽  
Cell Loss ◽  
Endothelial Keratoplasty ◽  
Endothelial Cell Loss ◽  
Descemet Stripping Endothelial Keratoplasty ◽  
Graft Thickness

Abstract Purpose To assess 2-year endothelial cell loss and graft survival after femtosecond laser semi-assisted Descemet stripping endothelial keratoplasty (FLS-DSEK). Methods In this prospective and noncomparative study carried out at Eye Hospital of Shandong First Medical University, 85 eyes (84 patients) with endothelial dysfunction receiving FLS-DSEK (n=62, 75.9%) or FLS-DSEK combined with phacoemulsification cataract surgery and intraocular lens implantation (n=23, 27.1%) from 2013 through 2016 were included. The graft endothelial cell loss, endothelial graft thickness, visual acuity, and complications after surgery were evaluated. Results Thin endothelial grafts were all successfully prepared, with no occurrence of perforation. The rate of endothelial cell loss was 17.4%, 18.8%, 19.9%, and 26.7%, and the central graft thickness was 113±54 μm, 102±40 μm, 101±28 μm, and 96±23 μm at 3, 6, 12, and 24 months, respectively. The median best-corrected visual acuity was 0.4 logMAR (range, 0–2 logMAR) at 24 months, demonstrating a significant difference from that before surgery (2 logMAR; range, 0.2–3 logMAR) (T=187.5, P<.001). Partial graft dislocation was the most common postoperative complication, with an occurrence rate of 14% (n=12), and it was associated with an abnormal iris-lens diaphragm (r=.35, P<.001). The other complications included a high intraocular pressure (n=5, 6%), endothelial graft rejection (n=4, 5%), and pupillary block (n=1, 1%). Endothelial graft decompensation occurred in the two eyes, and 98% (n=83) of the grafts survived at 24 months. Conclusions Data of the study suggest that the treatment using FLS-DSEK seems to be promising and might be considered a feasible choice in patients with endothelial dysfunction. Trial registration 1. Date of registration: 2021-02-18 2. Trial registration number: ChiCTR2100044091 3. Registration site: https://www.chictr.org.cn/

Endothelial Cell Loss After Needle-Push Insertion Descemet Stripping Endothelial Keratoplasty (DSEK)

Cornea ◽  
2016 ◽  
Vol 35 (6) ◽  
pp. e16-e17 ◽  
Author(s):  
Edward J. Casswell ◽  
Oliver Bowes ◽  
Allon Barsam ◽  
Henry D. Perry
Keyword(s):  
Endothelial Cell ◽  
Cell Loss ◽  
Endothelial Keratoplasty ◽  
Endothelial Cell Loss ◽  
Descemet Stripping Endothelial Keratoplasty

scholarly journals A Meta-Analysis Comparing Postoperative Complications and Outcomes of Femtosecond Laser-Assisted Cataract Surgery versus Conventional Phacoemulsification for Cataract

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Zi Ye ◽  
Zhaohui Li ◽  
Shouzhi He
Keyword(s):  
Visual Acuity ◽  
Endothelial Cell ◽  
Postoperative Complications ◽  
Femtosecond Laser ◽  
Cataract Surgery ◽  
Meta Analysis ◽  
Cell Loss ◽  
Corneal Endothelial Cell ◽  
Endothelial Cell Loss ◽  
Refractive Outcomes

Objective. This meta-analysis aimed to compare the outcomes and postoperative complications between femtosecond laser-assisted cataract surgery (FLACS) and conventional phacoemulsification cataract surgery (CPCS). Methods. Bibliographic databases, including PubMed, Embase, and Cochrane library, were systematically searched for references on or before September 2015 regarding the outcomes and complications by FLACS or CPCS. Data on corneal endothelial cell loss, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refractive outcomes, and postoperative complications were retrieved. Results. A total of 9 trials were included in this analysis. Refractive outcomes (MD = −0.21, 95% CI: −0.39~0.03, P=0.02) were significantly improved after FLACS. Although corneal endothelial cell loss was not significantly reduced after FLACS, there was a trend towards lower corneal endothelial cell loss (mean difference (MD) = 197.82, 95% confidence interval (CI): 2.66~392.97, P=0.05) after FLACS. There was no significant difference in UDVA (MD = −0.01, 95% CI: −0.13~0.10, P=0.80) or CDVA (MD = −0.03, 95% CI: 0.07~0.00, P=0.09) between the two surgeries. Elevated intraocular pressure and macular edema were most commonly developed complications after cataract surgery, and the incidence of these complications associated with the two surgeries was similar. Conclusion. Compared with CPCS, FLACS might achieve higher refractive stability and corneal endothelial cell count. Nevertheless, further study is needed to validate our findings.

scholarly journals Effect of Incision Width on Graft Survival and Endothelial Cell Loss After Descemet Stripping Automated Endothelial Keratoplasty

Cornea ◽  
2010 ◽  
Vol 29 (5) ◽  
pp. 523-527 ◽  
Author(s):  
Marianne O Price ◽  
Maria Bidros ◽  
Mark Gorovoy ◽  
Francis W Price ◽  
Beth A Benetz ◽  
...  
Keyword(s):  
Endothelial Cell ◽  
Graft Survival ◽  
Cell Loss ◽  
Endothelial Keratoplasty ◽  
Endothelial Cell Loss

scholarly journals Comparison of refractive predictability and endothelial cell loss in femtosecond laser-assisted cataract surgery and conventional phaco surgery: prospective randomised trial with 6 months of follow-up

2019 ◽  
Vol 4 (1) ◽  
pp. e000233 ◽  
Author(s):  
Therese Krarup ◽  
Rasmus Ejstrup ◽  
Anouck Mortensen ◽  
Morten la Cour ◽  
Lars Morten Holm
Keyword(s):  
Visual Acuity ◽  
Endothelial Cell ◽  
Femtosecond Laser ◽  
Cataract Surgery ◽  
Cell Loss ◽  
Absolute Difference ◽  
Endothelial Cell Loss ◽  
Distance Visual Acuity ◽  
The Mean

ObjectiveFemtosecond laser-assisted cataract surgery (FLACS) decreases the use of energy and provides a more precise capsulorhexis compared with conventional phaco surgery (CPS). The purpose of this study was to examine if the lower energy use in FLACS caused less endothelial cell loss compared with CPS and if there was a difference in refractive predictability between CPS and FLACS.Methods and analysisThis was a randomised controlled study of 96 patients with a 6-month follow-up comparing one eye surgery by FLACS and the contralateral eye operated by CPS (divide and conquer technique). Both eyes had intraocular aspheric lenses implanted. Uncorrected distance visual acuity, corrected distance visual acuity (CDVA), central corneal endothelial cell count and hexagonality (non-contact endothelial cell microscope) were assessed preoperatively at 40 and at 180 days postoperatively.ResultsThe mean phaco energies were 6.55 (95% CI 5.43 to 7.66) and 9.77 (95% CI 8.55 to 10.95) U/S (p<0.0001) by FLACS and CPS, respectively. At day 40, the mean endothelial cell loss (ECL) was 344 cells/mm2 (95% CI 245 to 443) by FLACS (12.89%) and 497 cells/mm2 (95% CI 380 to 614) by CPS (18.19%) (p=0.027). At day 180, ECL was 362 cells/mm2 (95% CI 275 to 450) in FLACS (13.56%) and 465 cells/mm2 (95% CI 377 to 554) in CPS (17.03%) (p=0.036).The mean absolute difference from the attempted refraction was 0.43 (95% CI 0.36 to 0.51) dioptres (D) at day 40 and 0.46 D (95% CI 0.39 to 0.53) at day 180 by FLACS compared with 0.43 D (95% CI 0.36 to 0.51) at day 40 (p=0.95) and 0.46 D (95% CI 0.37 to 0.52) at day 180 (p=0.91) with CPS.ConclusionECL was significantly lower in FLACS compared with CPS at both day 40 and day 180. ECL was correlated to the energy used. We found no difference in refractive predictability or CDVA between the groups.

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