scholarly journals Long-Term Evaluation of Capsulotomy Shape and Posterior Capsule Opacification after Low-Energy Bimanual Femtosecond Laser-Assisted Cataract Surgery

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Tommaso Verdina ◽  
Chiara Peppoloni ◽  
Lucrezia Barbieri ◽  
Maria Rosaria Carbotti ◽  
Bruno Battaglia ◽  
...  
Keyword(s):  
Endothelial Cell ◽  
Femtosecond Laser ◽  
Cataract Surgery ◽  
Cell Loss ◽  
Posterior Capsule Opacification ◽  
Low Energy ◽  
Endothelial Cell Loss ◽  
Significant Difference

Purpose. To evaluate capsulotomy shape and posterior capsule opacification (PCO) during an 18-month follow-up for bimanual femtosecond laser-assisted cataract surgery (FLACS). Methods. 74 eyes operated by a well-trained surgeon with bimanual FLACS technique using low-energy LDV Z8 (Ziemer Ophthalmic Systems AG, Port, Switzerland) were included in the study. The follow-up period was 18 ± 2 months. Another 91 eyes, which underwent standard bimanual microincision cataract surgery (B-MICS), served as a control group. In all cases, a BunnyLens AF (Hanita Lenses, Israel) intraocular lens was implanted in the bag. A digital image of the capsule with slit-lamp retroillumination was performed in all patients at 18 months of follow-up. Image analysis software (ImageJ) was used to evaluate the shape of the capsulotomy in terms of diameter, area, and circularity. PCO score was evaluated using EPCO 2000 software. Best corrected visual acuity (BCVA) and endothelial cell count (ECC) were evaluated before and after surgery at 1 and 18 ± 2 months. Results. At 18 months, mean capsulotomy diameter was 5.34 ± 0.21 mm while capsulorhexis was 5.87 ± 0.37 mm (p<0.001) and the deviation area from baseline was 1.13 ± 1.76 mm2 in FLACS and 2.67 ± 1.69 mm2 in B-MICS (p<0.001). Capsulotomy circularity was 0.94 ± 0.04 while capsulorhexis was 0.83 ± 0.07 (p<0.001). EPCO score was 0.050 ± 0.081 in the FLACS group and 0.122 ± 0.239 in the B-MICS group (p=0.03). The mean BCVA improvement was significant in both groups, without a significant difference at 18 months. We noticed a statistically significant difference in endothelial cell loss at 18 months (FLACS 12.4% and B-MICS 18.1%; p=0.017). Conclusions. Bimanual FLACS is a safe and effective technique, as determined in a long-term follow-up. Capsulotomy shape presented higher stability and circularity in the FLACS group over the 18-month observation period. FLACS resulted in lower PCO scores and endothelial cell loss at 18 months in comparison to B-MICS standard technique.

scholarly journals Comparison of refractive predictability and endothelial cell loss in femtosecond laser-assisted cataract surgery and conventional phaco surgery: prospective randomised trial with 6 months of follow-up

2019 ◽  
Vol 4 (1) ◽  
pp. e000233 ◽  
Author(s):  
Therese Krarup ◽  
Rasmus Ejstrup ◽  
Anouck Mortensen ◽  
Morten la Cour ◽  
Lars Morten Holm
Keyword(s):  
Visual Acuity ◽  
Endothelial Cell ◽  
Femtosecond Laser ◽  
Cataract Surgery ◽  
Cell Loss ◽  
Absolute Difference ◽  
Endothelial Cell Loss ◽  
Distance Visual Acuity ◽  
The Mean

ObjectiveFemtosecond laser-assisted cataract surgery (FLACS) decreases the use of energy and provides a more precise capsulorhexis compared with conventional phaco surgery (CPS). The purpose of this study was to examine if the lower energy use in FLACS caused less endothelial cell loss compared with CPS and if there was a difference in refractive predictability between CPS and FLACS.Methods and analysisThis was a randomised controlled study of 96 patients with a 6-month follow-up comparing one eye surgery by FLACS and the contralateral eye operated by CPS (divide and conquer technique). Both eyes had intraocular aspheric lenses implanted. Uncorrected distance visual acuity, corrected distance visual acuity (CDVA), central corneal endothelial cell count and hexagonality (non-contact endothelial cell microscope) were assessed preoperatively at 40 and at 180 days postoperatively.ResultsThe mean phaco energies were 6.55 (95% CI 5.43 to 7.66) and 9.77 (95% CI 8.55 to 10.95) U/S (p<0.0001) by FLACS and CPS, respectively. At day 40, the mean endothelial cell loss (ECL) was 344 cells/mm2 (95% CI 245 to 443) by FLACS (12.89%) and 497 cells/mm2 (95% CI 380 to 614) by CPS (18.19%) (p=0.027). At day 180, ECL was 362 cells/mm2 (95% CI 275 to 450) in FLACS (13.56%) and 465 cells/mm2 (95% CI 377 to 554) in CPS (17.03%) (p=0.036).The mean absolute difference from the attempted refraction was 0.43 (95% CI 0.36 to 0.51) dioptres (D) at day 40 and 0.46 D (95% CI 0.39 to 0.53) at day 180 by FLACS compared with 0.43 D (95% CI 0.36 to 0.51) at day 40 (p=0.95) and 0.46 D (95% CI 0.37 to 0.52) at day 180 (p=0.91) with CPS.ConclusionECL was significantly lower in FLACS compared with CPS at both day 40 and day 180. ECL was correlated to the energy used. We found no difference in refractive predictability or CDVA between the groups.

Long-term endothelial cell loss and breakdown of the blood-aqueous barrier in cataract surgery

1991 ◽  
Vol 17 (5) ◽  
pp. 622-627 ◽  
Author(s):  
V. M.G. Ambrose ◽  
R. F. Walters ◽  
M. Batterbury ◽  
D. J. Spalton ◽  
J. I. McGill
Keyword(s):  
Endothelial Cell ◽  
Cataract Surgery ◽  
Cell Loss ◽  
Endothelial Cell Loss ◽  
Blood Aqueous Barrier

scholarly journals Comparison of endothelial cell loss and complications between phacoemulsification and manual small incision cataract surgery (SICS) in uveitic cataract

2016 ◽  
Vol 7 (2) ◽  
pp. 124-134
Author(s):  
Rahul Bhargava ◽  
Shiv Kumar Sharma ◽  
Mini Chandra ◽  
Prachi Kumar ◽  
Yogesh Arora
Keyword(s):  
Endothelial Cell ◽  
Cataract Surgery ◽  
Cell Loss ◽  
Complication Rates ◽  
Endothelial Cell Loss ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Cell Counts ◽  
Endothelial Cell Counts

Introduction: Endothelial cell loss and complications after cataract surgery may be higher when cataract is complicated by uveitis.Objective: To compare endothelial cell damage and complication rates after phacoemulsification and manual small incision cataract surgery (SICS) in patients with uveitis.Materials and methods: Patients with uveitic cataract were randomly allocated for phacoemulsification (n=75) or manual SICS (n=80) in a double blind prospective study. In the bag implantation of a hydrophobic acrylic intraocular lens was aimed in all cases. Patients with follow up of less than six months were excluded. Main outcome measures were alteration in endothelial cell counts (ECC) and morphology, improvement in vision and complication rates. ECC was measured preoperatively and at 1 week, 3 months and six months, postoperatively.Results: Six patients were lost to follow up and another three due inability to implant IOL. There were no significant difference in endothelial cell counts (P= 0.032), the variance of endothelial cell size (CV) and percentage of hexagonal cells between both the groups at six months (Mann-Whitney test, P=0.283). Endothelial cell density was significantly less in the group in which vitrectomy and/or pupil dilatation procedures were performed (2290±31.5 cells/mm2) versus (2385±50.3 cells/mm2), respectively (t test, P<0.001). Incidence of postoperative complications that were observed like persistent uveitis (P=0.591), macular edema (P=0.671) and PCO (P=0.678) and visual outcome (P=0.974) were comparable between the two groups.Conclusions: Manual SICS and phacoemulsification do not differ significantly in endothelial cell loss and complication rates in uveitic eyes. However, increased anterior chamber manoeuvring due to additional procedures may lead to significantly higher endothelial cell loss.

scholarly journals New ophthalmic dual-viscoelastic device in cataract surgery: a comparative study

2019 ◽  
Vol 4 (1) ◽  
pp. e000280
Author(s):  
Gaspare Monaco ◽  
Mariangela Gari ◽  
Silvia Pelizzari ◽  
Arianna Lanfranchi ◽  
Giada Ruggi ◽  
...  
Keyword(s):  
Endothelial Cell ◽  
Cataract Surgery ◽  
Corneal Thickness ◽  
Cell Loss ◽  
Intraocular Inflammation ◽  
Significant Difference ◽  
Corrected Distance Visual Acuity ◽  
Randomised Controlled ◽  
Controlled Clinical Study

ObjectiveTo compare the performance and safety in cataract surgery of two ophthalmic viscoelastic devices (OVDs), each having separate dispersive and cohesive characteristics and different concentrations.Methods and analysisIn this prospective, randomised, controlled clinical study, one eye of each patient was injected with OVD1 (Viscopack14) or OVD2 (DuoVisc) during phacoemulsification and intraocular lens implantation. Endothelial cell count, intraocular pressure (IOP), central corneal thickness (CCT), intraocular inflammation and corrected distance visual acuity (CDVA) were compared 3 months postoperatively.ResultsThe study enrolled 127 patients. Randomisation assigned 50 eyes of as many patients to each arm of the study. The postoperative mean endothelial cell loss was 14.4% and 7.1% from baseline in the OVD1 and OVD2 groups, respectively (p=0.08). The incidence of IOP spikes at 2 hours was 0% and 8%, respectively (p=0.02). There were intergroup differences in postoperative IOP values, the OVD2 group showed significantly higher values at all of the follow-up visits starting from the 24 hours examination (p<0.05). There was no statistically significant difference in the CCT, intraocular inflammation and CDVA at the end of follow-up.ConclusionBoth OVDs showed similar clinical performances and were equally effective during cataract surgery. Viscopack14 showed more corneal endothelial cell reduction, while DuoVisc had more occurrences of IOP values and spikes. Future studies are mandatory to support these preliminary results.

scholarly journals A Meta-Analysis Comparing Postoperative Complications and Outcomes of Femtosecond Laser-Assisted Cataract Surgery versus Conventional Phacoemulsification for Cataract

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Zi Ye ◽  
Zhaohui Li ◽  
Shouzhi He
Keyword(s):  
Visual Acuity ◽  
Endothelial Cell ◽  
Postoperative Complications ◽  
Femtosecond Laser ◽  
Cataract Surgery ◽  
Meta Analysis ◽  
Cell Loss ◽  
Corneal Endothelial Cell ◽  
Endothelial Cell Loss ◽  
Refractive Outcomes

Objective. This meta-analysis aimed to compare the outcomes and postoperative complications between femtosecond laser-assisted cataract surgery (FLACS) and conventional phacoemulsification cataract surgery (CPCS). Methods. Bibliographic databases, including PubMed, Embase, and Cochrane library, were systematically searched for references on or before September 2015 regarding the outcomes and complications by FLACS or CPCS. Data on corneal endothelial cell loss, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refractive outcomes, and postoperative complications were retrieved. Results. A total of 9 trials were included in this analysis. Refractive outcomes (MD = −0.21, 95% CI: −0.39~0.03, P=0.02) were significantly improved after FLACS. Although corneal endothelial cell loss was not significantly reduced after FLACS, there was a trend towards lower corneal endothelial cell loss (mean difference (MD) = 197.82, 95% confidence interval (CI): 2.66~392.97, P=0.05) after FLACS. There was no significant difference in UDVA (MD = −0.01, 95% CI: −0.13~0.10, P=0.80) or CDVA (MD = −0.03, 95% CI: 0.07~0.00, P=0.09) between the two surgeries. Elevated intraocular pressure and macular edema were most commonly developed complications after cataract surgery, and the incidence of these complications associated with the two surgeries was similar. Conclusion. Compared with CPCS, FLACS might achieve higher refractive stability and corneal endothelial cell count. Nevertheless, further study is needed to validate our findings.

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