Abstract
The aim of this study was to evaluate corneal tissue trauma after femtosecond laser-assisted cataract surgery (FLACS) and phacoemulsification (femtophaco surgery) compared to FLACS and nanolaser emulsification (all laser surgery). This is a prospective nonrandomized clinical study conducted at the Ophthalmology Clinic, University “G. d’Annunzio” of Chieti-Pescara, Italy, involving forty-two eyes of 42 patients candidates to cataract surgery. Patients were enrolled in two groups: femtophaco surgery (group 1 with 21 eyes) and all laser surgery (group 2 with 21 eyes). Main outcome measures included uncorrected visual acuity and distance corrected visual acuity, corneal endothelial cell count, and corneal thickness at the tunnel site and at the center of the cornea. Best correct visual acuity was not significantly different between the two groups. Postoperatively, a significant decrement of endothelial cell count at the center of the cornea was observed in group 1 compared with preoperative values at 90 days (p < 0.001) while t remained stable in group 2. The central corneal thickness showed a statistically significant increase for both groups that reached a maximum thickness at 7 days and then returned to presurgery levels after 90 days for group 1 and after 60 days for group 2. The tunnel corneal thickness showed a statistically significant increase for both groups that reached a maximum thickness at 7 days, which did not return to presurgery level for group 1 but did return to presurgery levels after 60 days for group 2. All laser surgery induced lower central endothelial cell loss and lower increase of corneal thickness compared to femtophaco surgery.
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References
Stock G, Ahlers C, Dunavoelgyi R, Kahraman G, Schauersberger J, Schmidt-Erfurth U, Amon M (2011) Evaluation of anterior-segment inflammation and retinal thickness change following cataract surgery. Acta Ophthalmol 89:369–375
Berdahl JP, DeStafeno JJ, Kim T (2007) Corneal wound architecture and integrity after phacoemulsification evaluation of coaxial, microincision coaxial, and microincision bimanual techniques. J Cataract Refract Surg 33:510–515
Saeed MU, Jafree AJ, Saeed MS, Zia R, Sheikh IM, Heravi M (2012) Intraocular lens and capsule opacification with hydrophilic and hydrophobic acrylic materials. Semin Ophthalmol 27:15–18
He L, Sheehyb K, Culbertson W (2011) Femtosecond laser-assisted cataract surgery. Curr Opin Ophthalmol 22:43–52
Alió JL, Abdou AA, Puente AA, Zato MA, Nagy Z (2014) Femtosecond laser cataract surgery: updates on technologies and outcomes. J Refract Surg 30:420–427
Miháltz K, Knorz MC, Alió JL, Takács AI, Kránitz K, Kovács I, Nagy ZZ (2011) Internal aberrations and optical quality after femtosecond laser anterior capsulotomy in cataract surgery. J Refract Surg 27:711–716
Sándor GL, Kiss Z, Bocskai ZI, Kolev K, Takács AI, Juhász E, Kránitz K, Tóth G, Gyenes A, Bojtár I, Juhász T, Nagy ZZ (2014) Comparison of the mechanical properties of the anterior lens capsule following manual capsulorhexis and femtosecond laser capsulotomy. J Refract Surg 30:660–664
Mastropasqua L, Toto L, Mattei PA, Vecchiarino L, Mastropasqua A, Navarra R, Di Nicola M, Nubile M (2014) Optical coherence tomography and 3-dimensional confocal structured imaging system-guided femtosecond laser capsulotomy versus manual continuous curvilinear capsulorhexis. J Cataract Refract Surg 40:2035–2043
Mastropasqua L, Toto L, Mastropasqua A, Vecchiarino L, Mastropasqua R, Pedrotti E, Di Nicola M (2014) Femtosecond laser versus manual clear corneal incision in cataract surgery. J Refract Surg 30:27–33
Abell RG, Kerr NM, Vote BJ (2013) Toward zero effective phacoemulsification time using femtosecond laser pretreatment. Opthalmology 120:942–948
Mayer WJ, Klaproth OK, Hengerer FH, Kohnen T (2014) Impact of crystalline lens opacification on effective phacoemulsification time in femtosecond laser-assisted cataract surgery. Am J Opthalmol 157:426–432
Ho JW, Afshari NA (2015) Advances in cataract surgery: preserving the corneal endothelium. Curr Opin Ophthalmol 26:22–27
Conrad-Hengerer I, Al Jubury M, Schultz T, Hengerer FH, Dick HB (2013) Corneal endothelial cell loss and corneal thickness in conventional compared with femtosecond laser-assisted cataract surgery: three-month follow-. J Cataract Refract Surg 39:1307–1313
Kacerovska J, Kacerovsky M, Kadlec R (2013) Development of number of endothelial cells after cataract surgery performed by femtolaser in comparison to conventional phacoemulsification. Cesk Slov Oftalmol 69:215–218
Krarup T, Holm LM, La Cour M, Kjaerbo H (2014) Endothelial cell loss and refractive predictability in femtosecond laser-assisted cataract surgery compared with conventional cataract surgery. Acta Ophthalmol 92:617–622
Conrad-Hengerer I, Hengerer FH, Schultz T, Dick HB (2012) Effect of femtosecond laser fragmentation of the nucleus with different softening grid sizes on effective phaco time in cataract surgery. J Cataract Refract Surg 38:1888–1894
Kanellopoulos AJ, Photolysis Investigative Group (2001) Laser cataract surgery : a prospective clinical evaluation of 1000 consecutive laser cataract procedures using the Dodick photolysis Nd:YAG system. Ophthalmology 108:649–654
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The authors do not have any proprietary interest in the material described in this manuscript, and financial support was not received in support of the study.
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Mastropasqua, L., Mattei, P.A., Toto, L. et al. All laser cataract surgery compared to femtosecond laser phacoemulsification surgery: corneal trauma. Int Ophthalmol 37, 475–482 (2017). https://doi.org/10.1007/s10792-016-0283-7
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DOI: https://doi.org/10.1007/s10792-016-0283-7