Abstract:AIM: To investigate the effect of phacoemulsification assisted with femtosecond laser on corneal endothelial cells in patients with cataract.
METHODS: This was a prospective cohort study. We selected 180 patients(190 eyes)with cataract in our hospital from August 2014 to January 2016 treated with phacoemulsification combined with intraocular lens implantation. According to random number table, all patients were divided into observation group with 80 cases(85 eyes)and control group with 100 cases(105 eyes). Patients in the control group were treated by conventional phacoemulsification, and the observation group were treated by femtosecond laser assisted phacoemulsification. Two groups of patients with general information and clinical data, including age, sex, corneal endothelial cell count/mm2 before and at 3mo after the operation, cumulative dissipated energy(CDE)of the two groups, were collected. Statistical analysis was performed.
RESULTS: In the observation group, the level of CDE in patients with lens hardness at class Ⅱ and Ⅲ was significantly lower than that of the control group(t=-2.456, -3.053, P=0.016, 0.003). The reduction rate of CDE in patients with lens hardness at class Ⅱ was 29.37%, and the rate of CDE in patients at class Ⅲ was 22.69%, which was significantly lower than that of CDE in class Ⅱ. Comparison of preoperative corneal endothelial cell density was not significantly different between the two groups(t=-0.816, P=0.416); at 3mo after surgery, the corneal endothelial cell density of the observation group and the control group significantly decreased(t=-2.094, 6.043, P=0.038, <0.01). At 3mo after operation, the density of corneal endothelial cells of observation group was significantly higher than that of the control group(t=2.575, P=0.011). In the observation group, the rate of corneal endothelial cell loss(7.68±4.23)% was significantly lower than that of the control group(10.36±4.08)%.
CONCLUSION: For cataract patients with class Ⅲ and below nuclear, femtosecond laser assisted cataract surgery can reduce the level of CDE and reduce the damage to corneal endothelium, which is safe and effective.
