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Updated: Jun 27, 2025
Development of a Noninvasive, Laser-Assisted Experimental Model of Corneal Endothelial Cell Loss
Published on: April 24, 2020
Comparison of corneal endothelial cell loss in FLACS: impact on endothelial cells in different regions
Altantsetseg Altansukh1, Kathleen Sheng-Chuan Ma, Adiyabazar Doyodmaa
1From the Sasurea Eye Clinic, Ulaanbaatar, Mongolia (Altansukh); Department of Ophthalmology, Chang-Gung Memorial Hospital, Linkou, Taiwan (Altansukh, Hung, Kang, Ma); Department of Medicine, Catholic University of the Sacred Heart, Rome, Italy (Ma); Department of Ophthalmology, Gegeen Melmii Hospital, Ulaanbaatar, Mongolia (Doyodmaa); Department of Ophthalmology, Xiamen Chang Gung Hospital, Xiamen, China (Quan, Ma); Department of Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan (Ma); Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou, Taiwan (Ma).
Purpose:
To compare changes in corneal endothelial parameters after femtosecond laser-assisted cataract surgery (FLACS) and conventional phacoemulsification surgery (CPS) in different corneal regions.
Setting:
Chang Gung Memorial Hospital, Linkou, Taiwan.
Design:
Single-center, retrospective.
Methods:
Before and 1, 3, and 6 months postoperatively, specular microscopy was performed to measure endothelial cell density (ECD), corneal thickness, hexagonal cell rate (Hex), and coefficient of variation (CoV). Position 1 referred to the central cornea, position 2 was nearest to the main wound, and position 3 was at the peripheral zone diagonal to the main wound.
Results:
This study analyzed 96 eyes in the FLACS group and 110 eyes in the CPS group. Preoperatively, position 1 had lower ECD and CoV and higher Hex compared with the peripheral regions. FLACS patients had a significantly less phacoemulsification time and cumulative dissipated energy. At 1 month, FLACS patients showed a significantly smaller increase in corneal thickness at positions 1 and 2. At 3 months, FLACS patients had lower endothelial cell loss (ECL) at positions 1 and 3. ECL remained lower in FLACS patients at 6 months. The highest ECL was observed at position 2 in both groups and was progressive up to 6 months.
Conclusions:
After phacoemulsification, ECL varied in different corneal regions. At 3 months, the FLACS group exhibited significantly less ECL at the central cornea; however, the continued ECL at 6 months near the main wound suggested ongoing endothelial remodeling in the region.
