Refractive predictability and endothelial cell loss after femtosecond-assisted cataract surgery compared to conventional phaco surgery: a prospective randomized study of 109 patients with 6 months follow-up

Session Details

Session Title: Femtolaser-Assisted Cataract Surgery (FLACS) I

Session Date/Time: Sunday 08/10/2017 | 08:00-10:00

Paper Time: 09:08

Venue: Room 3.6

First Author: : T.Krarup DENMARK

Co Author(s): :    R. Ejstrup   A. Mortensen   M. la Cour   L. Holm           

Abstract Details

Purpose:

The purpose of the study was to compare refractive predictability and endothelial cell loss between femto-second laser assisted cataract surgery (FLACS) and conventional phaco surgery (CPS).

Setting:

Department of Ophthalmology, Copenhagen University Hospital Glostrup-Rigshospitalet, Copenhagen, Denmark

Methods:

109 patients were randomized into having one eye operated by FLACS and the contralateral eye operated by CPS (stop and chop technique). Exclusion criterias were history of intraocular surgery or eye trauma, keratoconus, corneal scars, visual significant retinopathy and proliferative vitreoretinopathy. All patients were operated by the same experienced surgeon and both eyes had intraocular aspheric lenses implanted. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), central corneal endothelial cell count and hexagonality (non contact endothelial cell microscope) were assessed preoperatively, 40 days postoperatively and 180 days postoperatively.

Results:

Six months postoperatively, mean ECL was 321 cells/mm2 (11.8%) (SD ± 329) by FLACS and 428 cells/mm2 (15.5%) (SD ± 356) by CPS, (p = 0.039). The mean absolute difference from the attempted refraction was 0.47 (SD ± 0.34) by FLACS and 0.43 D (SD ± 0.33) (p=0.47) by CPS. Mean CDVA was 1.01 (0.16;1.33) by FLACS and 1.01 (0.4;1.33) by CPS (p=0.95) at 6 months postoperatively. Mean fluid use was 58.6 (SD±19) by FLACS and 51.1 (SD±17) by CPS, (p < 0.001). Mean phaco energy was 6.52 U/S (SD±5.6) and 9.74 (SD±6.1) (p < 0.0001) by FLACS and CPS.

Conclusions:

Conclusion: FLACS was associated with a significant reduction of used phaco energy, significant increased use of fluid intraoperatively, and significant reduced endothelial cell loss at both day 40 and day 180 postoperatively compared to CPS. For both follow-up, we found no significant difference in refractive predictability and visual outcome between the two methods.

Financial Disclosure:

NONE