Femtosecond laser-assisted phacoemulsification minimizes corneal edema, trauma

Femtosecond laser-assisted cataract surgery resulted in less corneal swelling than the manual phacoemulsification technique, a study found.

“Corneal edema is one of the most frequent early postoperative complications of phacoemulsification, which can sometimes lead to permanent and serious visual disturbances,” the study authors said.

The prospective study included 38 eyes of 38 patients that underwent cataract surgery with the LenSx femtosecond laser (Alcon) or with the conventional manual technique.

Study results showed that at 1 day, central corneal thickness was 607 µm in the manual phacoemulsification group and 580 µm in the femtosecond laser group; the difference was statistically significant (P < .05). However, the between-group difference in central corneal thickness was insignificant at 1 week and 1 month.

Also at 1 day, the femtosecond laser group had a significantly lower corneal volume stress index than the manual phacoemulsification group (P < .05). However, the between-group difference was insignificant at 1 month.

The manual phacoemulsification group had slightly lower corneal endothelial cell counts at all follow-up points; the differences were statistically insignificant.

Phacoemulsification energy was significantly higher in the manual phacoemulsification group than in the femtosecond laser group. Phacoemulsification time was higher in the manual phacoemulsification group, but the difference was statistically insignificant.

Limitations of the study included lack of long-term analysis of endothelial cell morphology. In addition, patients were not matched based on lens density.

“Despite these limitations, our findings indicate that pre-chopping the nucleus with a femtosecond laser reduces phacoemulsification power and endothelial cell trauma, as compared to standard phacoemulsification,” the authors said.

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Source:

J Refract Surg. 2012;doi:10.3928/1081597X-20120508-02.