Comparison of Corneal Endothelial Cell Loss in Femtosecond Laser-assisted Cataract Surgery: Impact on Endothelial Cells in Different Regions

Altantsetseg Altansukh; Kathleen Sheng- Chuan Ma; Adiyabazar Doyodmaa; Ning Hung; Eugene Yu-Chuan Kang; Wuyong Quan; David Hui-Kang Ma

doi:10.1097/j.jcrs.0000000000001474

Comparison of Corneal Endothelial Cell Loss in Femtosecond Laser-assisted Cataract Surgery: Impact on Endothelial Cells in Different Regions

J Cataract Refract Surg. 2024 May 7. doi: 10.1097/j.jcrs.0000000000001474. Online ahead of print.

Authors

Altantsetseg Altansukh^{1

2}, Kathleen Sheng- Chuan Ma³, Adiyabazar Doyodmaa⁴, Ning Hung², Eugene Yu-Chuan Kang², Wuyong Quan⁵, David Hui-Kang Ma^{2

5

6

7}

Affiliations

¹ . Sasurea Eye Clinic, Ulaanbaatar, Mongolia.
² . Department of Ophthalmology, Chang-Gung Memorial Hospital, Linkou, Taiwan.
³ . Department of Medicine, Catholic University of the Sacred Heart, Rome, Italy.
⁴ . Department of Ophthalmology, Gegeen Melmii Hospital, Ulaanbaatar, Mongolia.
⁵ . Department of Ophthalmology, Xiamen Chang Gung Hospital, Xiamen, China.
⁶ . Department of Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
⁷ . Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou, Taiwan.

PMID: 38711211
DOI: 10.1097/j.jcrs.0000000000001474

Abstract

Purpose: To compare changes in corneal endothelial parameters following femtosecond laser-assisted cataract surgery (FLACS) and conventional phacoemulsification (CPS) in different corneal regions.

Setting: Chang Gung Memorial Hospital, Linkou, Taiwan, 2018- 2022.

Design: Single-center, retrospective.

Methods: Before and 1, 3, and 6 months post-op, specular microscopy was performed to measure endothelial cell density (ECD), corneal thickness, hexagonal cell rate (Hex), and coefficient of variation (CoV). Position 1 referred to the central cornea, Position 2 was nearest to the main wound, and Position 3 was at the peripheral zone diagonal to the main wound.

Results: This study analyzed 96 eyes in the FLACS group and 110 eyes in the CPS group. Preoperatively, Position 1 had lower ECD and CoV and higher Hex compared to the peripheral regions. FLACS patients had a significantly less phaco time and cumulative dissipated energy. At one month, FLACS patients showed a significantly smaller increase in corneal thickness at Positions 1 and 2. At 3 months, FLACS patients had lower endothelial cell loss (ECL) at Positions 1 and 3. ECL remained lower in FLACS patients at 6 months. The highest ECL was observed at Position 2 in both groups and was progressive up to 6 months.

Conclusions: Following phacoemulcification, ECL varied in different corneal regions. At 3 months, the FLACS group exhibited significantly less ECL at the central cornea; however, the continued ECL at 6 months near the main wound suggested ongoing endothelial remodeling in the region.