Femtosecond laser–assisted cataract surgery: First clinical results with special regard to central corneal thickness, endothelial cell count, and aqueous flare levels

BACKGROUND The main attributes of cornea which makes it optically important is its ability to maintain its dehydrated state. This corneal dehydration can be achieved and maintained by various factors among which corneal endothelial cell count and morphology play a significant role. Corneal attributes considered in this study i.e. the corneal endothelial cell count and central corneal thickness are extremely variable, and changes are seen even with smaller changes in anterior segment or overall structural changes in eyes. We wanted to compare central corneal thickness in emmetropia and axial myopia and compare corneal endothelial cell count in emmetropia and axial myopia. METHODS The sample size was decided taking into consideration various prevalence studies. The patients were consecutively recruited for the study considering the inclusion and exclusion criteria. The subjects were divided into two groups emmetropia and axial myopia and were differentiated on the basis of the axial lengths. Specular microscopy was performed for the subjects and corneal endothelial cell count, morphology and central corneal thickness were measured, and comparative study was performed. RESULTS This study of 80 eyes shows us that the difference between mean the corneal endothelial cell count between emmetrope (2812.80 cells / mm2) and axial myopes (2653 cells / mm2) is statistically significant where p was < 0.05 while the mean central corneal thickness measurements didn’t show statistically significant change between emmetrope (490.05 microns) and axial myope. (489.37 microns). CONCLUSIONS Axial length has an indirect correlation with the corneal endothelial cell count which is statistically significant. While significant correlation between the central corneal thickness and axial length cannot be established in this study. KEY WORDS Emmetropia, Axial Myopia, Corneal Endothelial Cell Count, Central Corneal Thickness, Comparison

Download Full-text

Bimanual femtosecond laser-assisted cataract surgery compared to standard bimanual phacoemulsification: A case–control study

European Journal of Ophthalmology ◽

10.1177/1120672118805323 ◽

2018 ◽

Vol 29 (6) ◽

pp. 629-635 ◽

Cited By ~ 2

Author(s):

Gian Maria Cavallini ◽

Elisa Fornasari ◽

Michele De Maria ◽

Andrea Lazzerini ◽

Luca Campi ◽

...

Keyword(s):

Endothelial Cell ◽

Femtosecond Laser ◽

Cataract Surgery ◽

Cell Count ◽

Low Energy ◽

Endothelial Cell Count ◽

Group A ◽

Induced Astigmatism ◽

Group B ◽

Surgically Induced

Purpose: To evaluate the efficacy and safety of bimanual, low-energy femtosecond laser-assisted cataract surgery with 1.4-mm microincisions compared to standard bimanual phacoemulsification (bimanual microincision cataract surgery). Design: Prospective, non-randomized comparative case series. Methods: Bimanual femtosecond laser-assisted cataract surgery with microincisions was performed on 80 eyes (Group A) with the low-energy Ziemer LDV Z8; a matched case–control series of 80 eyes performed with standard bimanual microincision cataract surgery technique was selected for comparison (Group B). All interventions were performed by the same experienced surgeon. Intraoperative parameters were recorded as well as intra- and postoperative complications. Best corrected visual acuity, surgically induced astigmatism, central corneal thickness and endothelial cell count were evaluated before surgery and at 1 and 3 months post intervention. Results: The mean effective phaco times were 3.79 ± 2.19 s (Group A) and 4.49 ± 1.84 s (Group B) (p = 0.041). No major intra- or postoperative complications occurred. An overall significant mean best corrected visual acuity improvement was noted at 3 months, but was not statistically different between the groups. No significant changes were observed for surgically induced astigmatism or corneal pachymetry. A significant loss of endothelial cell count in both groups was detected at 3 months, with Group A reporting a significantly lower endothelial cell count loss compared to Group B (p = 0.009). Conclusion: Bimanual, low-energy femtosecond laser-assisted cataract surgery with 1.4-mm microincisions by an expert surgeon was proven to be safe and effective in this study. This technique has advantages compared with standard bimanual microincision cataract surgery in terms of endothelial preservation.

Download Full-text

Corneal endothelial cell count following femtosecond laser-assisted cataract surgery versus conventional phacoemulsification

Journal of the Egyptian Ophthalmological Society ◽

10.4103/2090-0686.192747 ◽

2016 ◽

Vol 109 (1) ◽

pp. 21

Author(s):

LamiaS Elewa ◽

Yasser El-Zankalony ◽

SafaaS.M. Saleh

Keyword(s):

Endothelial Cell ◽

Femtosecond Laser ◽

Cataract Surgery ◽

Cell Count ◽

Corneal Endothelial Cell ◽

Endothelial Cell Count

Download Full-text

Comparison of changes in corneal endothelial cell density and central corneal thickness between conventional and femtosecond laser-assisted cataract surgery: a randomised, controlled clinical trial

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-313723 ◽

2019 ◽

Vol 104 (2) ◽

pp. 225-229 ◽

Cited By ~ 2

Author(s):

Daliya Dzhaber ◽

Osama Mustafa ◽

Fares Alsaleh ◽

Aleksandra Mihailovic ◽

Yassine J Daoud

Keyword(s):

Clinical Trial ◽

Endothelial Cell ◽

Femtosecond Laser ◽

Cataract Surgery ◽

Central Corneal Thickness ◽

Corneal Thickness ◽

Controlled Clinical Trial ◽

Randomised Controlled Clinical Trial ◽

Randomised Controlled

Background/AimTo identify changes in endothelial cell density (ECD) and central corneal thickness (CCT) in eyes undergoing femtosecond laser-assisted cataract surgery (FLACS) compared with conventional phacoemulsification surgery (CPS).MethodsThis is an intraindividual randomised, controlled clinical trial. One eye was randomised to receive FLACS, while the contralateral eye of the same patient received CPS. The femtosecond laser pretreatment included creating main and side-port corneal incisions, capsulotomy and lens fragmentation. Non-contact endothelial cell microscopy and pachymetry were performed preoperatively and at postoperative day 1, week 1, month 1 and month 3.ResultsA total of 134 paired eyes from 67 patients were included in the analysis. ECD was not significantly different between the two groups at either postoperative month 1 (2370±580 cells/mm2 and 2467±564 cells/mm2 in FLACS and CPS groups, respectively; p=0.18) or at postoperative month 3 (2374±527 cells/mm2 and 2433±526 cells/mm2 in FLACS and CPS groups, respectively; p=0.19). No significant difference was observed in the mean CCT values between the two groups over the follow-up period (p>0.05).ConclusionPostoperative corneal ECD and CCT were comparable between FLACS and CPS during the 3 months’ follow-up period.

Download Full-text