Corneal Endothelial Cell Changes After Femtosecond Laser–Assisted Cataract Surgery in Diabetic and Nondiabetic Patients

Kang, Kyoung Hae; Song, Mi Kyoung; Kim, Kook Young; Hwang, Kyu Yeon; Kwon, Yumi; Koh, Kyungmin

doi:10.1097/icl.0000000000000823

Cited by 11 publications

(7 citation statements)

References 42 publications

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“…Femtosecond laser-assisted cataract surgery (FLACS) is reported to cause less damage to the corneal endothelium in patients with DM and can reduce the ECL. This may be because the corneal endothelial injury caused by the small energy during FLACS is insufficient to cause significant damage [ 44 ]. Therefore, FLACS may be a better option for patients with DM than conventional phacoemulsification.…”

Section: Discussionmentioning

confidence: 99%

Meta-analysis of corneal endothelial changes after phacoemulsification in diabetic and non-diabetic patients

et al. 2023

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Background Currently, there is still controversy about the differential changes in corneal endothelium function and morphology after phacoemulsification between Diabetes Mellitus (DM) and non-Diabetes Mellitus (non-DM) patients. In this study, we aimed to evaluate the influence of phacoemulsification on the corneal endothelium in DM and non-DM patients. Methods Databases of PubMed, Embase, Web of Science, and the Cochrane Library were searched for studies published between January 1, 2011 and December 25, 2021. The weighted mean difference and 95% confidence interval were used to estimate the outcomes of statistical analyses performed. Results Thirteen studies involving 1744 eyes were included in this meta-analysis. No significant difference was observed in the central corneal thickness (CCT), endothelial cell density (ECD), coefficients of variation (CV), or hexagonal cell percentage (HCP) between the DM and non-DM groups (CCT: P = 0.91; ECD: P = 0.07; CV: P = 0.06; HCP: P = 0.09) preoperatively. The CCT was significantly thicker in the DM group at 1 month (P = 0.003) and 3 months (P = 0.0009) postoperatively, and there was no significant difference at 6 months postoperatively (P = 0.26) than non-DM group. The CV was significantly higher and HCP was significantly lower in the DM group at 1 month (CV:P < 0.0001, HCP: P = 0.002), with no significant difference at 3 months (CV: P = 0.09, HCP: P = 0.36) and 6 months (CV: P = 0.32, HCP: P = 0.36) postoperatively than non-DM group. DM patients had lower ECD than non-DM patients at all postoperative time points (1 month, 3 months: P < 0.00001, 6 months: P < 0.0001). Conclusions The influence of phacoemulsification on corneal endothelial damage is greater in diabetic patients. Moreover, the recovery of corneal endothelial function and morphology is delayed in these patients. Clinicians should be more attentive to the corneal health of DM patients when considering phacoemulsification.

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Section: Discussionmentioning

confidence: 99%

Meta-analysis of corneal endothelial changes after phacoemulsification in diabetic and non-diabetic patients

et al. 2023

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“…The femtosecond laser can accurately determine the diameter of the capsulorhexis, and create CCC, which can make a more centered and more circular opening, thereby avoiding the complications related to capsulorhexis to the greatest extent [51][52] . By segmenting the nucleus, femtosecond laser-assisted cataract surgery can reduce thermal or ultrasound energy and in turn protect the corneal endothelium [53] . Pajic et al [54] found that femtosecond laser-assisted cataract surgery could provide a reproducible capsulotomy and highly effective lens nucleus technology, which could bring good postoperative visual acuity and surgical safety.…”

Section: Discussionmentioning

confidence: 99%

Bibliometric analysis of research relating to refractive cataract surgery over a 20-year period: from 2003 to 2022

Chen,

Xie,

Zhang

et al. 2023

Int J Ophthalmol

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AIM: To investigate the research trend on refractive cataract surgery, compare the contributions of different countries, institutions, journals, and authors in the past 20y, and explore its potential research hotspots. METHODS: All publications were extracted relating to refractive cataract surgery from 2003 to 2022 from Web of Science. Document types were limited to original articles and reviews, and the language was limited to English. Quantitatively and qualitatively of the publications were analyzed through Microsoft Excel and GraphPad Prism. VOSviewer and CiteSpace were used for bibliometric and visualized analysis. RESULTS: A total of 2090 publications were enrolled. The United States contributed the most publications (434, 20.8%), followed by China (345, 16.5%) and England (163, 7.80%). Publications from the United States were cited more frequently (9552 citations) with the highest H-index of 48. China ranked second in the total number of publications, the papers were not cited that frequently (3237 citations), and the H-index ranked sixth (H-index=29). Journal of Cataract and Refractive Surgery published the most papers (333, 15.9%), and the University of London had the highest number of publications (75, 3.59%). Dick HB from Germany published the most papers. Corneal astigmatism-related research, cataract surgery method-related research, postoperative visual-quality relate to research, and postoperative complications-relate research are the hotspots in this field. The most significant limitation was that the database was updated frequently and the latest publications were not included. CONCLUSION: The bibliometric analysis shows a brief summarization of the contribution of the authors, institutions, countries, and journals. Corneal astigmatism, cataract surgery method, postoperative visual-quality and postoperative complications related researches have become the emerging hotspots, which can give a direction in the future researches.

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“…Separately, Cruz et al [ 28 ] demonstrated that in patients with diabetes and moderate cataracts, FLACS resulted in higher postoperative endothelial cell density when compared to CPCS at 3 months postoperatively, suggesting that there may be a protective role of FLACS in this group of patients as well. Likewise, Kang et al [ 29 ] also demonstrated that there was significantly thinner CCT in diabetics undergoing FLACS compared to CPCS.…”

Section: Endothelial Compromisementioning

confidence: 97%

Femtosecond laser-assisted cataract surgery for complex cataracts – A review

Chen,

Chee

2024

Indian Journal of Ophthalmology

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Since its inception in 2009, femtosecond laser-assisted cataract surgery (FLACS) has become an alternative to conventional phacoemulsification cataract surgery (CPCS). Clinical studies were unable to demonstrate superior visual outcomes, but revealed reduced endothelial cell loss. More recently, the cost-effectiveness of FLACS over CPCS in routine cataract surgeries has been challenged. However, the unique abilities of FLACS to customize anterior capsulotomies precisely, soften and fragment the nucleus without capsular bag stress, and create corneal incisions may have special utility in complex cataract and less-common scenarios. In this article, we review the unique role of FLACS in complex cataract surgeries and how it could play a role to improve the safety and predictability of nonroutine cataract surgery.

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Corneal Endothelial Cell Changes After Femtosecond Laser–Assisted Cataract Surgery in Diabetic and Nondiabetic Patients

Cited by 11 publications

References 42 publications

Meta-analysis of corneal endothelial changes after phacoemulsification in diabetic and non-diabetic patients

Meta-analysis of corneal endothelial changes after phacoemulsification in diabetic and non-diabetic patients

Bibliometric analysis of research relating to refractive cataract surgery over a 20-year period: from 2003 to 2022

Femtosecond laser-assisted cataract surgery for complex cataracts – A review

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