Central Corneal Volume and Endothelial Cell Count Following Femtosecond Laser-assisted Refractive Cataract Surgery Compared to Conventional Phacoemulsification

Purpose: To compare the effect of conventional phacoemulsification and femtosecond laser-assisted cataract surgery on the cornea using Scheimpflug imaging and noncontact specular microscopy.

Methods: In each group, 38 eyes (38 patients) underwent cataract surgery using either femtosecond laser-assisted (Alcon LenSx laser) (femtolaser group) or conventional phacoemulsification (phaco group). Central corneal thickness, 3-mm corneal volume, and Pentacam Nucleus Staging (PNS) were determined by a rotating Scheimpflug camera (Pentacam HR, Oculus Optikgeräte GmbH), and the volume stress index was calculated at 1 day and 1 month postoperatively. Endothelial cell count was measured by noncontact specular microscopy preoperatively, 1 day, 1 week, and 1 month postoperatively.

Results: Central corneal thickness was significantly higher in the phaco group (607±91 μm) than in the femtolaser group (580±42 μm) on day 1, but did not differ significantly preoperatively and at 1 week and 1 month. Volume stress index at day 1 was significantly lower in the femtolaser group than in the phaco group (P<.05) but did not differ significantly at 1 month. Multivariate regression analysis showed that the type of surgery had a significant effect on central corneal thickness.

Conclusions: Femtosecond laser-assisted cataract surgery causes less corneal swelling in the early postoperative period and may cause less trauma to corneal endothelial cells than manual phacoemulsification.