Effects of femtosecond laser-assisted phacoemulsification on corneal endothelial cells, visual quality and tear inflammatory indicators in cataract patients

  Objective  To explore the effects of femtosecond laser-assisted phacoemulsification on corneal endothelial cells, visual quality and tear inflammatory indicators in cataract patients.

  Methods  A total of 72 patients (101 eyes) with cataract who underwent femtosecond laser-assisted phacoemulsification in our hospital from January to December 2018 were selected as observation group. Another 72 patients (98 eyes) who underwent traditional phacoemulsification were included in control group. The intraoperative general indicators incision diameter of anterior capsule, size of capsule membrane, cumulative dissipated energy of grade Ⅱ nucleus and grade Ⅲ nucleus (CDE), and pre-and post-operative corneal endothelial cells-related indicators corneal endothelial cell density, coefficient of variation and proportion of hexagonal cells, visual quality best corrected visual acuity (BCVA), total higher order aberration (HOA), modulation transfer function (MTF) and tear inflammatory indicatorsinterleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-α (TNF-α) and transforming growth factor-β₁ (TGF-β₁) before and after surgery were compared between the two groups.

  Results  The incision diameter of anterior capsule, eye capsule membrane size, grade Ⅱ nucleus CDE and grade Ⅲ nucleus CDE in observation group were significantly lower than those in control group (P < 0.05). At 3 months after surgery, the corneal endothelial cell density and proportion of hexagonal cells in the two groups were significantly decreased compared with before surgery, while the coefficient of variation was significantly increased (P < 0.05), and the degree of decreases or increase in observation group were smaller than those in control group (P < 0.05). The BCVA and MTF values at 1 week and 3 months after surgery in the two groups were significantly higher than that before operation (P < 0.05), while the HOA was significantly lower than that before operation (P < 0.05); and the BCVA in observation group at 1 week after surgery was significantly higher than that in control group (P < 0.05), and the HOA at 1 week and 3 months after surgery in the observation group was significantly lower than that in control group (P < 0.05), while the MTF value was significantly higher than that in control group (P < 0.05). The levels of tear inflammatory factors such as IL-6, IL-8, TNF-α and TGF-β₁ in the two groups at 1 week after surgery were increased compared with surgery before (P < 0.05), but were gradually returned to normal at 3 months after surgery, and there were no significant differences between the two groups (P>0.05).

  Conclusion  Compared with traditional phacoemulsification, femtosecond laser-assisted phacoemulsification has less damage to corneal endothelial cells in cataract patients, and can gain better visual quality in early postoperative period, but it has no obvious advantage in control of postoperative tear inflammatory indicators.