A 24-month Analysis of Endothelial Cell Loss at Three Different Positions between Femtosecond Laser-assisted and Conventional Phacoemulsification.

Abstract

Purpose: To compare long-term changes in endothelial cell loss (ECL) in different corneal regions after femtosecond laser-assisted cataract surgery (FLACS) or conventional phacoemulsification surgery (CPS).

Setting: Chang Gung Memorial Hospital, Linkou, Taiwan.

Design: Single-center retrospective study.

Methods: Adult patients who received a premium IOL via FLACS or CPS were included. Patients with an endothelial count less than 1,500 cells/mm2, NO5/NC5 nuclear sclerosis, and complications during surgery were excluded. All patients were followed at 1, 3, 6, 12, and 24 months postoperatively. ECL was measured at different positions of the cornea: Position 1, the corneal center; Position 2, nearest the main corneal incision; and Position 3, the peripheral region opposite the main wound.

Results: 48 eyes in the CPS group and 40 eyes in the FLACS group from 75 patients were included. In both groups, ECL was consistently greater at Position 2, and ECL at Positions 1 and 3 remained relatively stable across all time points. At postoperative 3 months at Position 3: the FLACS group had significantly lower ECL than the CPS group. However, at Position 2, ECL continued to increase until 6 months and then stabilized. No significant differences in other endothelial parameters, including the coefficient of variation, percentage of hexagonal cells, or corneal thickness, were observed between the two groups.

Conclusions: A significant difference in ECL between FLACS and CPS occurred only in the early postoperative period. ECL was highest near the main wound in both groups; it peaked at 6 months postoperatively and stabilized thereafter.