Nanosecond laser–assisted cataract surgery: Endothelial cell study

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Abstract
To evaluate corneal endothelial cell density (ECD) and morphology after cataract surgery using coaxial ultrasound (US) phacoemulsification or a recently introduced coaxial nanosecond laser technique. Department of Ophthalmology, Medical University of Sofia, Sofia, Bulgaria. Prospective cohort study. Coaxial US phacoemulsification was performed in 1 eye (US group) and coaxial nanosecond laser-assisted cataract surgery in the contralateral eye (laser group) of the same patient. Nuclear sclerosis was graded from nuclear opalescence (NO) 3, nuclear color (NC) 3 to NO4, NC4 using the Lens Opacities Classification System III. The central ECD, coefficient of variation (CoV) in cell size (objective measure of polymegethism), and percentage of hexagonal cells (an index of pleomorphism) were evaluated. Eighty-two eyes (41 patients) had uneventful surgery. The mean ECD was 2517 cells/mm(2) ± 137 (SD) preoperatively and 2287 ± 155 cells/mm(2) at 2 years in the US group and 2521 ± 233 cells/mm(2) and 2420 ± 292 cells/mm(2), respectively, in the laser group (both P < .001). The mean CoV was 0.27 ± 2.4 preoperatively and 0.30 ± 2.4 at 2 years in the US group and 0.27 ± 2.8 and 0.27 ± 2.0, respectively, in the laser group (both P < .001). The mean percentage of hexagonal cells was 42.3% ± 3.6% preoperatively and 37.74% ± 3.54% at 2 years in the US group and 42.8% ± 3.2% and 43.00% ± 2.68%, respectively, in the laser group (both P < .001). Nanosecond laser phacoemulsification had advantages over US phacoemulsification in terms of endothelial cell structure preservation. Dr. Kanellopoulos is consultant to Alcon Surgical, Inc., Allergan, Inc., Avedro, Inc., Keramed, Inc., Optovue, Inc., i-Optics Corp., and Carl Zeiss Meditec AG. Neither of the other authors has a financial or proprietary interest in any material or method mentioned.

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