Effect of Femtosecond Laser-Assisted Cataract Surgery (FLACS) on Endothelial Cell Count

Abstract

Objective: To compare the change in endothelial cell count after femtosecond laser-assisted cataract surgery (FLACS) versus conventional phacoemulsification.

Study design: Randomized controlled clinical trial.

Place and duration of study: Armed Forces Institute of Ophthalmology, Rawalpindi, Pakistan from January 2016 to August 2017.

Methodology: Patients with senile cataract and age ranging from 40 to 80 years were included in the study. Patients with any other cause of endothelial cell loss, history of trauma, documented diabetes millitis, hypertention and glaucoma were excluded. Preoperative detailed ocular examination, including both anterior and posterior examination, was carried out. Patients were distributed into two groups. Group GP were planned for conventional phacoemulsification, while group GF underwent FLACS. All the surgeries were performed under local anesthesia by same ophthalmic surgeon. Specular microscope (Topcon specular microscope sp-3000p) was utilized to measure the endothelial cell count (ECC) before and 4 weeks after the surgery.

Results: Fifty eyes (25 in each group) of 48 patients underwent cataract surgery by phacoemulsification or FLACS. Twenty-five (52.08%) out of the total were females while 23 (47.91%) were males. Median age of the participants in phacoemulsification group was 55 years (IQR 20.50), while in FLACS group it was 54 years (IQR 8). The median change in endothelial cell count was 228 (IQR 532) in Phaco group, while 23 (IQR 35) in FLACS group. (p<0.05 Mann Whitney U-test).

Conclusion: FLACS is a safe and effective modality for cataract treatment and it induces significantly less endothelial cell loss than conventional phacoemulsification.