title: Endothelial cell loss and refractive predictability in femtosecond laser-assisted cataract surgery compared with conventional cataract surgery.
abstract: OBJECTIVE
  To investigate the amount of endothelial cell loss (ECL) and refractive predictability by femtosecond laser-assisted cataract surgery (FLACS) compared to conventional phacoemulsification cataract surgery (CPS).
  
  
  METHODS
  Forty-seven patients had one eye operated by FLACS and the contralateral eye operated by CPS (stop and chop technique). Both eyes had intraocular aspheric lenses implanted. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), central corneal endothelial cell count and hexagonality with a non-contact specular microscope were assessed preoperatively, 1-3 days postoperatively and 3 months postoperatively.
  
  
  RESULTS
  Three days postoperatively, mean ECL was 249 cells/mm(2) (SD ± 744) (9.1%) by FLACS and 235 cells/mm(2) (SD ± 681) (8.2%) by CPS (p = 0.87). Three months postoperatively, mean ECL was 274 cells/mm(2) (SD ± 358) (11.4%) by FLACS compared with 333 cells/mm(2) (SD ± 422) (13.9%) by CPS, (p = 0.30) 3 months postoperatively, hexagonality was decreased by 1.8% (SD ± 30) by FLACS and by 1.4% (SD ± 13) by CPS, (p = 0.84). The mean absolute difference from the attempted refraction was 0.37 dioptres (D) (SD ± 0.33) by FLACS and 0.41 D (SD ± 0.42) by CPS (p = 0.56). Mean CDVA was 0.89 (0.3; 1.25) by FLACS and 0.93 (0.4; 1.25) by CPS at 3 months postoperatively (p = 0.36). Within both groups, 70% gained a CDVA of 6/6. Mean surgery time was 9.3 min (SD ± 1.9) by FLACS and 8.0 min (SD ± 1.9) by CPS, (p = 0.0018). Mean phaco energy was 3.78 U/S (SD ± 5.1) and 5.45 U/S (SD ± 4.6) (p < 0.0001) by FLACS and CPS, respectively.
  
  
  CONCLUSIONS
  We found no significant difference in ECL and refractive predictability between FLACS and CPS 3 months postoperatively.
authors.affiliation: Department of Ophthalmology, Copenhagen University Hospital Glostrup, Copenhagen, Denmark.
authors.forename: Therese
authors.initials: T
authors.lastname: Krarup
authors.forename: Lars Morten
authors.initials: LM
authors.lastname: Holm
authors.forename: Morten
authors.initials: M
authors.lastname: la Cour
authors.forename: Hadi
authors.initials: H
authors.lastname: Kjaerbo
mesh_terms: D000328:Adult; D002387:Cataract Extraction / Q000379:methods*; D002452:Cell Count; D055954:Corneal Endothelial Cell Loss / Q000175:diagnosis*; D004728:Endothelium, Corneal / Q000473:pathology; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D019654:Lens Implantation, Intraocular; D018918:Phacoemulsification / Q000379:methods; D011446:Prospective Studies; D012030:Refractive Errors / Q000175:diagnosis*; D014792:Visual Acuity
keywords: LensAR; cataract surgery; corneal endothelial cell loss; femtosecond-assisted cataract surgery; phaco energy