Femtosecond laser-assisted cataract surgery in Fuchs endothelial corneal dystrophy: Long-term outcomes

Abstract

Purpose: To compare the corneal endothelial cell loss and central corneal thickness (CCT) after conventional phacoemulsification surgery or femtosecond laser-assisted cataract surgery in patients with Fuchs endothelial corneal dystrophy and senile cataract.

Setting: Xiamen Ophthalmic Center, Affiliate Xiamen University, Xiamen, China.

Design: Prospective case series.

Methods: Eyes with mild or moderate Fuchs endothelial corneal dystrophy and cataracts had femtosecond laser-assisted cataract surgery or phacoemulsification. The endothelial cell density (ECD), rate of ECD loss, cumulative dissipated energy (CDE), and CCT were measured preoperatively and 3 days and 1, 3, 6, and 12 months postoperatively.

Results: The study evaluated 31 eyes. The CDE was lower in the femtosecond group than in the phacoemulsification group (P < .05). The preoperative and postoperative ECDs were similar in the 2 groups (P > .05). The rate of ECD loss was higher in the phacoemulsification group from 1 to 12 months postoperatively (P > .05). The CCT was thicker in the phacoemulsification group 1, 3, and 6 months postoperatively (all P > .05). In both groups, the postoperative CCT at all follow-up visits were greater than the preoperative CCT (all P < .01). No bullous keratopathy or other intraoperative complications occurred in either group during the follow-up.

Conclusions: For eyes with Fuchs endothelial corneal dystrophy and cataract, the CCT 12 months after surgery remained thicker than the preoperative thickness. The femtosecond group, with a lower CDE, tended to have a thinner CCT and less endothelial cell loss than the phacoemulsification group.