Corneal endothelial cell loss induced by femtosecond laser-assisted cataract surgery without ophthalmic viscoelastic devices

Resumen

PURPOSE: To evaluate corneal endothelial cell loss after femtosecond laser-assisted cataract surgery (FLACS) performed without ophthalmic viscosurgical devices (OVD), compared with FLACS with OVD. SETTING: Clínica Rementería, Madrid, Spain. METHODS: Patients scheduled for cataract surgery willing to participate underwent FLACS without OVD (Group 1). Age-matched patients operated with OVD were included as a control Group (Group 2). All patients underwent an extensive examination before and one month after surgery, including: best-corrected visual acuity (BCVA), tonometry, apex corneal pachymetry and specular microscopy. An OVD was used to complete the capsulotomy and fi ll the capsular bag prior to intraocular lens (IOL) insertion in eyes in Group 2, while no OVD was used in eyes in Group 1, in which a bimanual irrigation handpiece was employed to distend the capsular bag during IOL injection. RESULTS: Sixty-four eyes of 64 patients were included in each group. Th ere were no signifi cant diff erences in mean age, preoperative BCVA, nuclear cataract grade, anterior chamber depth, apex corneal pachymetry or endothelial cell count. Patients in Group 2 lost signifi cantly more endothelial cells one month after surgery (10.1 ± 14.79% compared to baseline) than patients in Group 1 (3.7 ± 20.71%, p = 0.047). One week apex corneal thickness was signifi cantly higher in Group 2 compared to Group 1 (570 ± 36.0 μm vs. 554 ± 34.9 μm, p = 0.03).Th ere were no signifi cant diff erences in mean intraocular pressure (IOP) or IOP spikes between both groups. CONCLUSION: FLACS without OVD does not seem to have a negative impact on endothelial cell loss after surgery.