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Endothelial cell loss in femtosecond laser-assisted cataract surgery: 6 months follow-up

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Session Details

Session Title: FLACS II

Session Date/Time: Monday 07/09/2015 | 14:30-16:00

Paper Time: 15:24

Venue: Room 16

First Author: : T.Krarup DENMARK

Co Author(s): :    C. Mette   R. Ejstrup   A. Mortensen   M. la Cour   L. Holm        

Abstract Details


To investigate the amount of endothelial cell loss (ECL) and refractive predictability between femtosecond laser-assisted cataract surgery (FLACS) and conventional phacoemulsification surgery (CPS).


Department of Ophthalmology, Glostrup, University hospital of Copenhagen, Denmark


38 patients had one eye operated by FLACS and the contralateral eye operated by CPS (stop and chop technique). Exclusion criterias were history of intraocular surgery or eye trauma, keratoconnus, corneal scars, visual significant retinopathy and proliferative vitreoretinopathy. All patients were randomized and were operated on by the same experienced cataract surgeon. Both eyes had intraocular aspheric lenses implanted. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), central corneal endothelial cell count and hexagonality with a non-contact specular microscope were assessed preoperatively, 40 days postoperatively and 6 months postoperatively.


Six months postoperatively, mean ECL was 322 cells/mm(2) (11%) (SD ± 333) by FLACS compared with 344 cells/mm(2) (12%) (SD ± 267) by CPS, (p = 0.84). The mean absolute difference from the attempted refraction was 0.34 (SD ± 0.31) by FLACS and 0.48 (SD ± 0.26) (p=0.2) by CPS. Mean CDVA was 0.97 (SD±0.25) by FLACS and 0.9 (SD±0.18) by CPS (p=0.65) at 6 months postoperatively. Mean fluid use was 57.5 (SD±20) by FLACS and 51.7 (SD±18) by CPS, (p = 0.03). Mean phaco energy was 6.39 (SD±6.0) and 9.4 (SD±5.9) (p < 0.0005) by FLACS and CPS.


FLACS was associated with a significant reduction of used phaco energy, significant increased use of fluid intraoperatively, and better CDVA when compared to CPS. For both follow-ups we found no significant difference in ECL and refractive predictability between the two methods.

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