Comparing corneal outcome between femtosecond laser-assisted cataract surgery and conventional phaco surgery in Fuchs’ endothelial dystrophy patients: A randomized pilot study with 6mo follow up

Therese Krarup*, Kathrine Rose, Aurore Marie-Laurence, Akp Mensah, Morten la Cour, Lars Morten Holm

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

2 Citations (Scopus)
13 Downloads (Pure)

Abstract

AIM: To compare the corneal outcome in Fuchs’ endothelial dystrophy (FED) patients between femtosecond laser-assisted cataract surgery (FLACS) and conventional phaco surgery (CPS). METHODS: This was a randomized controlled study comparing one eye surgery by FLACS and the contralateral eye operated by CPS (stop and chop technique) in FED patients. Central corneal thickness, corneal light backscatter, corneal densitometry, and central corneal endothelial cell count and hexagonality (noncontact endothelial cell microscope), and corrected distance visual acuity (CDVA) were assessed preoperatively and at day 1, 40, and 180 postoperatively. RESULTS: Totally 31 patients (16 women) were included. At day 40 postoperatively, the mean endothelial cell loss (ECL) was 23.67% by FLACS and 17.30% by CPS (P=0.53). At day 180 postoperatively, ECL was 25.58% in FLACS and 21.32% in CPS (P=0.69). Densitometry data in all layers and all annuli from anterior layer to posterior layer in annuli 0-2, 2-6, 6-10 and 10-12, total densitometry with all layers and all annuli was performed. A significant difference was found in 6-10 (posterior layer) at day 1 with -1.42 grayscale units (GSU; 95%CI: -2.66 to -0.19, P=0.02). In 10-12 (anterior layer, central layer and all layers) at day 40 were significant different with 7.7 (95%CI: 1.89 to 13.50, P=0.009), 3.97 (95%CI: 0.23 to 7.71, P=0.03), 4.73 GSU (95%CI: 0.71 to 8.75, P=0.02), respectively. In the remaining parameters we found no difference between the two groups (P>0.05). Three CPS eyes suffered from corneal decompensation. CONCLUSION: There is no significant difference in corneal outcome between FLACS and CPS. Endothelial cell density and pentacam corneal outcome may be inadequate as outcome parameters in FED patients.

Original languageEnglish
JournalInternational Journal of Ophthalmology
Volume14
Issue number5
Pages (from-to)684-692
ISSN2222-3959
DOIs
Publication statusPublished - 2021

Bibliographical note

Publisher Copyright:
© 2021 International Journal of Ophthalmology (c/o Editorial Office). All rights reserved.

Keywords

  • Cataract surgery
  • Central corneal thickness
  • Corneal endothelial cell loss
  • Femtosecond-assisted cataract surgery
  • Fuchs’ endothelial dystrophy
  • Pentacam

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