Comparison of changes in corneal endothelial cell density and central corneal thickness between conventional and femtosecond laser-assisted cataract surgery: a randomised, controlled clinical trial

Dzhaber, Daliya; Mustafa, Osama M.; Alsaleh, Fares; Mihailović, Aleksandra; Daoud, Yassine J.

doi:10.1136/bjophthalmol-2018-313723

Cited by 43 publications

(36 citation statements)

References 34 publications

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“…76 While another study found that while there was no difference in ECL between eyes undergoing FLACs or CPS at 6 months, FLACS eyes with FL CCIs had greater ECL than those with manual corneal incisions, suggesting that FL CCIs may negate some of the benefit of reduced phacoemulsification time on ECL. 77 More recently, in two randomised prospective studies by Dzhaber et al 78 in 134 eyes and Roberts et al 49 in 400 eyes showed no post-operative differences between FLACS and CPS at 3 and 1 month, respectively.…”

Section: Fl-assisted Nuclear Fragmentationmentioning

confidence: 94%

“…Several studies have investigated the possibility of reduced ECL after FLACS compared with CPS. 75–78 One intra-individual study showed no difference between FLACS and CPS in ECL at 3 months. 76 While another study found that while there was no difference in ECL between eyes undergoing FLACs or CPS at 6 months, FLACS eyes with FL CCIs had greater ECL than those with manual corneal incisions, suggesting that FL CCIs may negate some of the benefit of reduced phacoemulsification time on ECL.…”

Section: Fl-assisted Nuclear Fragmentationmentioning

confidence: 99%

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Femtosecond laser–assisted cataract surgery: A review

Roberts,

Day,

O’Brart

2019

European Journal of Ophthalmology

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Purpose: Review scientific literature concerning femtosecond laser–assisted cataract surgery. Methods: Following databases were searched: CENTRAL (Cochrane Eyes and Vision Trials Register; Cochrane Library: Issue 2 of 12, June 2019), Ovid MEDLINE® without Revisions (1996 to June 2019), Ovid MEDLINE® (1946 to June 2019), Ovid MEDLINE® Daily Update June 2019, MEDLINE and MEDLINE Non-Indexed Items, Embase (1980–2019), Embase (1974 to June 2019), Ovid MEDLINE® and Epub Ahead of Print, in-Process & Other Non-Indexed Citations and Daily (1946 to June 2019), Web of Science (all years), the metaRegister of Controlled Trials ( www.controlled-trials.com ), ClinicalTrials.gov ( www.clinicaltrial.gov ) and World Health Organization International Clinical Trials Registry Platform ( www.who.int/ictrp/search/en ). Search terms/keywords included ‘Femtosecond laser’ combined with ‘cataract’, ‘cataract surgery’. Results: Based on quality of their methodology and their originality, 121 articles were reviewed, including randomised controlled trials, cohort studies, case-controlled studies, case series, case reports and laboratory studies. Each step of the femtosecond laser–assisted cataract surgery procedure (corneal incisions, arcuate keratotomies, capsulotomy and lens fragmentation) has been discussed with relevance to published outcomes, as well as complication rates of femtosecond laser–assisted cataract surgery, and what we can learn from the larger studies/meta-analyses and the economics of femtosecond laser–assisted cataract surgery within different healthcare settings. Conclusion: Studies suggest that the current clinical outcomes of femtosecond laser–assisted cataract surgery are not different to conventional phacoemulsification surgery and it is not cost effective when compared with conventional phacoemulsification surgery. In its current technological form, it is a useful surgical tool in specific complex cataract scenarios, but its usage has not been shown to translate into better clinical outcomes.

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Section: Fl-assisted Nuclear Fragmentationmentioning

confidence: 94%

Section: Fl-assisted Nuclear Fragmentationmentioning

confidence: 99%

Femtosecond laser–assisted cataract surgery: A review

Roberts,

Day,

O’Brart

2019

European Journal of Ophthalmology

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“…Wang et al reported no statistical significant differences in CCT between MICS and SICS. [46,48] Other authors in their studies also were no noted any differences in CCT between studied groups. [34,40,45,50] On the other hand, the irrigation solution volume used during the entire procedure should be taken into account.…”

Section: Discussionmentioning

confidence: 78%

“…[[11-13,39-44] In contrary to our study Bascaran et al did not found significant differences between the two groups in endothelial cell density loss and CCT either. [45,46] In turn, in the group B and in the group C there were no statistically significant differences in the loss of endothelial cells between studied groups. Similarly to our study Mencucci et al and Wang et al were no found significant differences in corneal endothelial cell loss or endothelial morphology between MICS and standard incision techniques.…”

Section: Discussionmentioning

confidence: 80%

Comparison of the selected parameters of the anterior segment of the eye between femtosecond laser-assisted cataract surgery, microincision cataract surgery, and conventional phacoemulsification

Chlasta-Twardzik

Nowińska²,

Wylęgała³

2019

Medicine

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The purpose of our study was to compare the selected parameters of the anterior segment of the eye in patients after femtosecond laser-assisted cataract surgery (FLACS) with the results of microincision cataract surgery (MICS) and conventional phacoemulsification surgery (CPS). This single-center prospective randomized comparative observational study included 87 patients. Patients were randomly selected into group A (FLACS), group B (MICS) and group C (control group). All the surgeries were performed by the same experienced surgeon. Preoperative and postoperative parameters were evaluated: best-corrected visual acuity (BCVA), endothelial cell density (ECD), endothelial cell loss percentage (ECL%), central corneal thickness (CCT), central anterior and posterior corneal astigmatism induction, posterior corneal elevation map were measured. Intraoperative parameters: effective phacoemulsification time (EPT), balanced salt solution use (BSS use), total surgical time and suction time were analyzed. Examination was performed preoperatively and on the first, seventh day, one and six months postoperatively. The follow up period was 6 months. There was no statistically significant difference in BCVA, central anterior and posterior astigmatism induction between studied groups. The ECL% was statistically significant lower in the group A on the 7th day, 1 month and 6-months postoperatively (P < .05). The CCT was statistically significant lower in the group A and in the group B than in the group C on the 7th postoperative day (P = .002). However, in the 6 months follow-up there was no statistically significant difference in the CCT between studied groups (P = .133). We observed statistically significant difference in change of the posterior corneal elevation map at the periphery assessed within the 90°to 120°meridian range between group A, group B and group C at every timepoint postoperatively (P < .05). The EPT and BSS use were statistically significant lower whilst total surgery time was statistically significant higher in the FLACS group (P < .05). To conclude in the 6 months follow-up there was statistically significant difference found between eyes undergoing FLACS, MICS and CPS with respect to the posterior corneal elevation map assessed within the studied range, ECL%, EPT, BSS use and total surgery time. Postoperative BCVA, central anterior and posterior astigmatism induction, CCT were comparable between studied groups.Abbreviations: BCVA = best-corrected visual acuity, BSS use = balanced salt solution use, CCT = central corneal thickness, CPS = conventional phacoemulsification surgery, ECD = endothelial cell density, ECL% = endothelial cell loss percentage, EPT = effective phacoemulsification time, FDA = Food and Drug Administration, FLACS = femtosecond laser-assisted cataract surgery, IOL = intraocular lens, LCS = laser cataract surgery, LOCS = Lens Opacities Classification System, MICS = microincision cataract surgery, NC = nuclear color, NO = nuclear opacity, OVD = ophthalmic viscosurgical device, RCTs = randomized ...

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“…Several studies have investigated the effect of FS laser-assisted cataract surgery on anterior chamber in ammation and corneal endothelium [16][17][18]. Furthermore, the effects of LASIK performed with MMKs, excimer laser with super cial ablation as photorefractive keratectomy (PRK), and even radial keratotomy and intrastromal rings on in ammation in the anterior chamber have been investigated [12,19,20].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Effect of Myopic Femtosecond Laser Assisted-LASIK on Anterior Chamber Flare Values and Corneal Endothelial Cells: A Prospective Before-and-After Study

Özbilen

Altınkurt

Ceylan

et al. 2021

Preprint

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Purpose This study aimed to investigate whether femtosecond laser-assisted LASIK (FS-LASIK) surgery causes inflammation in the anterior chamber and to analyze its effect on endothelial cells.Methods This prospective, longitudinal study included 60 eyes of 30 patients (19 females) who had undergone FS-LASIK surgery due to myopia and myopic astigmatism. Endothelial cell density (ECD) and morphological measurements were performed using a specular microscopy, and laser flare photometry was used to measure the anterior chamber flare values on the day of surgery. iFS™ Advanced FS and VISX STAR S4-IR Wavescan Excimer Laser platforms were used. Flare measurements were repeated on the postoperative 1st day and 7th day and the 1st and 3rd months. The endothelial measurements were repeated in the 3rd month.Results Preoperatively, the mean flare was 5.34 ± 1.13 photons/ms; it was 6.02 ± 2.0 on the postoperative 1st day, 5.78 ± 1.98 on the 7th day, 5.77 ± 3.16 in the 1st month, and 5.45 ± 1.13 in the 3rd month. A significant difference was observed between the preoperative values and the postoperative 1st day values (p = 0.010). The decrease in the ECD was statistically significant, with an average of 120.3 ± 260 cell-count/mm2 (p = 0.001) and a minimal change in the coefficient of variation (p = 0.043). A significant correlation was found between the increase in the flare value on the postoperative 1st day and the preoperative flare value (r = -0.281, p = 0.015). A significant correlation was found between the decrease in ECD and the preoperative ECD (r = 0.434, p < 0.001)Conclusion FS-LASIK only causes minimal inflammation in the anterior chamber on the 1st preoperative day; additionally, a statistically significant decrease of 4.2% and minimal morphological changes were noted in the endothelial cells.

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Comparison of changes in corneal endothelial cell density and central corneal thickness between conventional and femtosecond laser-assisted cataract surgery: a randomised, controlled clinical trial

Cited by 43 publications

References 34 publications

Femtosecond laser–assisted cataract surgery: A review

Femtosecond laser–assisted cataract surgery: A review

Comparison of the selected parameters of the anterior segment of the eye between femtosecond laser-assisted cataract surgery, microincision cataract surgery, and conventional phacoemulsification

Evaluation of the Effect of Myopic Femtosecond Laser Assisted-LASIK on Anterior Chamber Flare Values and Corneal Endothelial Cells: A Prospective Before-and-After Study

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