Effect of Myopic Femtosecond Laser-Assisted LASIK on Anterior Chamber Inflammation (Flare Values) and Corneal Endothelium: A Prospective before and after Study.

Kemal Turgay Özbilen,Nilüfer Gözüm,Gizem Sayar Bilgin,Emre Altinkurt,Nihan Aksu Ceylan

doi:10.1155/2021/2395028

Abstract

Purpose This study aimed to investigate whether femtosecond laser-assisted LASIK (FS-LASIK) surgery causes inflammation in the anterior chamber and to analyze its effect on endothelial cells. Methods This prospective, longitudinal study included left eyes of 30 patients (19 females) who had undergone FS-LASIK surgery due to myopia and myopic astigmatism. Endothelial cell density (ECD) and morphological measurements were performed using a specular microscopy, and laser flare photometry was used to measure the anterior chamber flare values on the day of surgery. iFS™ Advanced FS and VISX STAR S4-IR Wavescan Excimer Laser platforms were used. Flare measurements were repeated on the postoperative 1st day and 7th day and the 1st and 3rd months. The endothelial measurements were repeated in the 3rd month. Results Preoperatively, the mean flare was 5.59 ± 1.24 photons/ms; it was 6.49 ± 2.42 on the postoperative 1st day, 5.87 ± 2.27 on the 7th day, 5.68 ± 1.66 on the 1st month, and 5.35 ± 1.24 on the 3rd month. A significant difference was observed only between the preoperative and postoperative 1st day flare values (p=0.047). The decrease in the ECD was clinically insignificant but statistically significant, with an average of 97.0 ± 209.9 cell count/mm2 (3.3%, p=0.017). However, there was no significant change in the coefficient of variation (p=0.448) and hexagonality (p=0.096). No significant correlation was found between the increase in the flare value on the postoperative 1st day and variables. A significant correlation was found between the decrease in ECD and the preoperative ECD (r = 0.356, p=0.027). Conclusion FS-LASIK caused minimal inflammation in the anterior chamber on only the 1st postoperative day; additionally, a minimal decrease of cell count with no morphological changes were noted in the endothelial cells on postoperative 3rd month. This trial is registered with NCT04899258.

Highlights

Purpose. is study aimed to investigate whether femtosecond laser-assisted laser in situ keratomileusis (LASIK) (FS-LASIK) surgery causes inflammation in the anterior chamber and to analyze its effect on endothelial cells
The effects of LASIK performed with mechanical microkeratomes (MMKs), excimer laser with superficial ablation as photorefractive keratectomy (PRK), and even radial keratotomy and intrastromal rings on inflammation in the anterior chamber have been investigated [12, 19, 20]
No significant abnormality in endothelium functions was observed clinically, some statistically significant changes were observed in specular microscopy measurements. e mean Endothelial cell density (ECD) was decreased with an average of 97.0 ± 209.9 (3.3%) cell count/mm2 (p 0.017)

Summary

Introduction

Purpose. is study aimed to investigate whether femtosecond laser-assisted LASIK (FS-LASIK) surgery causes inflammation in the anterior chamber and to analyze its effect on endothelial cells. Is study aimed to investigate whether femtosecond laser-assisted LASIK (FS-LASIK) surgery causes inflammation in the anterior chamber and to analyze its effect on endothelial cells. The effects of LASIK performed with MMKs, excimer laser with superficial ablation as photorefractive keratectomy (PRK), and even radial keratotomy and intrastromal rings on inflammation in the anterior chamber have been investigated [12, 19, 20]. Since FS-LASIK surgery is applied using both an FS laser and an excimer laser, we aimed to determine the direct and indirect effects of these applications on the corneal endothelium, the intensity of the inflammation, and the blood-aqueous barrier in the anterior chamber. Erefore, we evaluated these effects using objective measurement methods, such as specular microscopy and laser flare photometry To the best of our knowledge, the effects of FS-LASIK on anterior chamber inflammation have not been previously investigated. erefore, we evaluated these effects using objective measurement methods, such as specular microscopy and laser flare photometry

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Conclusion