Corneal endothelial cell changes following Femtosecond laser - assisted cataract surgery versus phacoemulsification

The aim
Is to compare the safety of femtosecond laser-assisted cataract surgery versus conventional phacoemulsification on the corneal endothelial cell changes.
Method
Prospective, randomized study of 30 eyes underwent femtosecond laser-assisted cataract surgery and 30 eyes underwent conventional phacoemulsification between January and September 2016 at a private ophthalmology clinic in Alexandria. Femtosecond laser-assisted cataractsurgery involved cornealincision, anteriorcapsulotomy, and lens fragmentation based on optical coherence tomography-guided treatment mapping. Conventional procedure involved manual continuous curvilinear capsulorrhexis. Both procedures were completed by means of standard phacoemulsification and insertion of an intraocular lens. Endothelial cell count was measured with a Tommy EM 3000 Specular microscope preoperatively and 1 and 3 month postoperatively.
Results
Central corneal thickness in femtosecond lasr assisted cataract surgery (FLACS) group was 545.87±29.045 μm, whereas in phaco group was 541.43±36.606 μm, with no statistically significant difference between the two groups preoperatively and 1 week postoperatively. Effective phacoemulsification time was reduced by 52% in the FLACS group (<0.0001), and cumulative dissipated energy was reduced by 45% in FLACS group (<0.0001). A larger amount of fluid was used in conventional haco surgery (CPS) more than FLACS, with a statistically significant difference (regarding using divide-and-conquer technique in conventional phaco group in phaco one step) (<0.05). There was no significant change in corneal endothelial cell count between the two groups.
Conclusions
Femtosecond laser-assisted cataract surgery appears to be as safe as conventional cataract surgery regarding central corneal thickness and corneal endothelial cell count with lower effective phacoemulsification time and cumulative dissipated energy in femtosecond laser-assisted cataract surgery.