Comparison of fibrotic response in the human lens capsular bag after femtosecond laser–assisted cataract surgery and conventional phacoemulsification

Abstract

To compare the effect of different laser pulse energy settings in femtosecond laser-assisted cataract surgery with that of standard phacoemulsification and no energy at all used on posterior capsule opacification (PCO) invitro. Cell and Molecular Biology Research Laboratory, Department of Ophthalmology, Ludwig-Maximilians-University Munich, Real Eyes, Ophthalmology Center, Munich, and Institute for Clinical Pathology, Goethe University Frankfurt, Frankfurt, Germany. Experimental study. Fifteen cadaver capsular bags were cultivated from 8 human donors under standard cell culture conditions. For preparation of the capsular bag, 4 groups were established as follows: femtosecond laser-assisted cataract surgery standard energy (n=3), femtosecond laser-assisted cataract surgery high energy (n=3), phacoemulsification (n=6), and hydrodissection without energy (extracapsular cataract extraction) (n=3). Growth of lens epithelial cells was observed and photodocumented. The days until full cell coverage of the posterior capsule were documented. Capsular bags were stained for fibronectin, α-smooth muscle actin, and collagen type1. Cell growth patterns in all treatment groups were comparable, with no statistically significant differences detected at any timepoint measured (P=.81, Kruskal-Wallis). The markers for fibrosis were equally distributed in all groups, indicating an equal fibrotic reaction in all groups. Femtosecond laser-assisted cataract surgery did not increase different cellular responses in PCO formation comparison with phacoemulsification invitro, even when higher laser pulse energy levels were used.