Induced changes in macula and endothelium after femtosecond laser-assisted cataract surgerycomparison with standard phacoemulsification

Résumé

OBJECTIVES: To study the changes in the macula and corneal endothelium after femtosecondassisted cataract surgery compared with standard coaxial phacoemulsification. SETTING: Ophthalmology Clinic in Madrid, Spain. METHODS: Patients with an indication for cataract surgery were evaluated prospectively for inclusion in the study. Patients choosing to undergo standard phacoemulsification were included in group 1 and patients choosing femtosecond-assisted cataract surgery were included in group 2. All patients underwent an extensive ophthalmic evaluation before and one month after surgery, including best corrected visual acuity, Goldmann applanation tonometry, endothelial confocal microscopy and spectral domain optical coherence tomography (SD-OCT). Changes produced by the surgical procedure within each group were also analyzed and compared between both groups. RESULTS: We included 66 eyes in group 1 and 68 eyes in group 2. After surgery, a decrease in endothelial cell density was observed in both groups (Group 1: −4.70% ±15.78%; Group 2: −4.24% ±15.04%) with no significant statistical differences between groups (p = 0.942). Central macular thickness and macular volume increased after surgery in Group 1; +1.36 % ±5.72 and +1.02 % ±2.84% respectively. In Group 2 both parameters decreased −0.25% ±8.44% and −0.10 % ±4.02% respectively. The difference between the percentage of change in each group was not statistically significant (p = 0.372 and p = 0.069, respectively) CONCLUSION: No statistically significant differences were found between either group in terms of the percentage of change in endothelial cell count, macular volume and central macular thickness one month after surgery. The observed macular changes were not clinically relevant.