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Development of a Noninvasive, Laser-Assisted Experimental Model of Corneal Endothelial Cell Loss

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Nanosecond laser-assisted cataract surgery: Endothelial cell study.

Ivan Tanev¹, Vesselin Tanev¹, Anastasios John Kanellopoulos¹

¹From the Department of Ophthalmology (I. Tanev), Faculty of Medicine, Medical University, and the Eye Hospital Zrenie (V. Tanev), Sofia, Bulgaria; the LaserVision.gr Clinical & Research Eye Institute (Kanellopoulos), Athens, Greece; the New York University Medical School (Kanellopoulos), New York, New York, USA.

Journal of Cataract and Refractive Surgery

|June 4, 2016

Summary

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Nanosecond laser cataract surgery better preserves corneal endothelial cells compared to traditional ultrasound phacoemulsification, showing improved cell density and morphology two years post-operation.

Area of Science:

Ophthalmology
Biomedical Engineering
Surgical Technology

Background:

Cataract surgery is a common procedure to restore vision.
Corneal endothelial cells are crucial for corneal clarity and function.
Maintaining endothelial cell health post-surgery is vital for long-term visual outcomes.

Purpose of the Study:

To compare the effects of coaxial ultrasound (US) phacoemulsification and a nanosecond laser technique on corneal endothelial cell density (ECD) and morphology.
To evaluate long-term changes in endothelial cell structure after these cataract surgery methods.

Main Methods:

A prospective cohort study involving 41 patients undergoing bilateral cataract surgery.
One eye received coaxial US phacoemulsification, while the contralateral eye underwent coaxial nanosecond laser-assisted surgery.

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Corneal endothelial cell density, cell size variation (polymegethism), and hexagonal cell percentage (pleomorphism) were measured preoperatively and two years post-surgery.

Main Results:

Both methods showed a statistically significant decrease in ECD and hexagonal cells, and an increase in cell size variation at two years.
The nanosecond laser group demonstrated better preservation of endothelial cell structure compared to the US phacoemulsification group.
Specific data showed mean ECD changes from 2521 to 2420 cells/mm² for laser vs. 2517 to 2287 cells/mm² for US; mean hexagonal cells from 42.8% to 43.00% for laser vs. 42.3% to 37.74% for US.

Conclusions:

Nanosecond laser cataract surgery offers advantages in preserving the corneal endothelium compared to traditional ultrasound phacoemulsification.
The nanosecond laser technique appears to be a gentler alternative for maintaining endothelial cell health post-surgery.