Femtosecond laser–assisted cataract surgery in Fuchs endothelial corneal dystrophy: Long-term outcomes

Abstract

To compare the corneal endothelial cell loss and central corneal thickness (CCT) after conventional phacoemulsification surgery or femtosecond laser-assisted cataract surgery in patients with Fuchs endothelial corneal dystrophy and senile cataract. Xiamen Ophthalmic Center, Affiliate Xiamen University, Xiamen, China. Prospective case series. Eyes with mild or moderate Fuchs endothelial corneal dystrophy and cataracts had femtosecond laser-assisted cataract surgery or phacoemulsification. The endothelial cell density (ECD), rate of ECD loss, cumulative dissipated energy (CDE), and CCT were measured preoperatively and 3days and 1, 3, 6, and 12months postoperatively. The study evaluated 31 eyes. The CDE was lower in the femtosecond group than in the phacoemulsification group (P<.05). The preoperative and postoperative ECDs were similar in the 2 groups (P>.05). The rate of ECD loss was higher in the phacoemulsification group from 1 to 12months postoperatively (P>.05). The CCT was thicker in the phacoemulsification group 1, 3, and 6months postoperatively (all P>.05). In both groups, the postoperative CCT at all follow-up visits were greater than the preoperative CCT (all P<.01). No bullous keratopathy or other intraoperative complications occurred in either group during the follow-up. For eyes with Fuchs endothelial corneal dystrophy and cataract, the CCT 12months after surgery remained thicker than the preoperative thickness. The femtosecond group, with a lower CDE, tended to have a thinner CCT and less endothelial cell loss than the phacoemulsification group.