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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

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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.

OriginalsprogEngelsk
TidsskriftInternational journal of ophthalmology
Vol/bind14
Udgave nummer5
Sider (fra-til)684-692
Antal sider9
ISSN2222-3959
DOI
StatusUdgivet - 2021

Bibliografisk note

International Journal of Ophthalmology Press.

ID: 68764790