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Gábor Sándor, Ágnes Takács, Kinga Kranitz, Eva Juhasz, Illes Kovacs, Zoltan Nagy, Cornea Study Group; Comparison of early corneal peripherial endothelial cell loss following femtosecond laser - assisted cataract surgery and conventional phacoemulsification. Invest. Ophthalmol. Vis. Sci. 2013;54(15):1649.
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To compare early corneal peripherial endothelial cell loss after femtosecond laser - assisted cataract surgery and conventional phacoemulsification, using non-contact specular microscopy.
In each group, 15 eyes (15 patients) underwent cataract surgery using either femtosecond - laser assisted (Alcon LenSx laser system, femtolaser group) or conventional phacoemulsification (phaco group). All operations were performed by the same surgeon with the same phaco machine (Infiniti, Alcon). Biometry was performed using Lenstar LS 900 (Haag-Streit AG) non-contact optical low-coherence reflectometer. Scheimpflug camera (Pentacam HR, Oculus Optikgerate GmbH) was used to measure nucleus density (Pentacam Nucleus Staging; PNS). Endothelial cell density was measured by Specular Microscope NSP-9900 (Konan Nonco Robo) preoperatively and 1 month after surgery by a semiautomated masked manner. The measurements were performed at four identical points on the peripherial area of the cornea. The mean value was used as the average cell density of periphery. For comparison of independent variables Mann Whitney U-test, and for comparison of dependent variables Wilcoxon-test was used.
There was no statistically significant difference in demographics, PNS, axial lenght, phaco energy and effective phaco time between the two study groups. We found no significant difference in preoperative cell density in the two groups (femtolaser group: 2898±168/mm2, phaco group: 2799±219/mm2, p=0,1776). 1 month after the surgery the cell density was slightly lower in the phaco group (2696±233/mm2) than in the femtolaser group (2833±140/mm2), but the difference was not statistically significant (p=0,0887). The peripherial endothelial cell loss was significant in both the phaco group (4%, p=0,004) and the femtolaser group (2%, p=0,005).
Results of this study suggest that femtosecond laser-assisted cataract surgery does not significantly differ in early corneal peripherial endothelial cell loss from manual phacoemulsification. There is a smaller tendency of decrease in peripherial endothelial cell count after femtosecond laser-assisted cataract surgery compared with conventional phacoemulsification, however the difference is not statistically significant.
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