Comparison of changes in ECD and CCT between CPS and FLACS
Reviewed by Jonathan Chan

This is an intraindividual randomised clinical trial of 134 eyes from 67 patients, one eye was treated with femtosecond laser-assisted cataract surgery (FLACS) (including pretreatment of main incision, side port, capsulotomy and lens fragmentation) and the fellow eye received conventional phacoemulsification cataract surgery (CPS). Preoperative measurements were non-contact endothelial cell microscopy and pachymetry, and were repeated at day one, one week, one month and three months postoperatively. Intraoperatively, balanced salt solution (BSS) use, irrigation / aspiration time for cortex removal and operating room (OR) time were significantly longer in the FLACS group (p<0.001). There was no significant difference between the two groups for corneal endothelial density (ECD) at postoperative month one or three (p=0.18 and 0.19 respectively). The mean central corneal thickness (CCT) values did not show any significant difference between the two groups either, p>0.05. The authors conclude that both surgical techniques were comparable during the three month period for postoperative CCT and ECD analysis. They also proposed further study for longer duration (greater than six months) and FLACS technique without FL- assisted corneal incision for possible extra corneal (ECD) protection.

Comparison of changes in corneal endothelial density (ECD) and central corneal thickness (CCT) between conventional (CPS) and femtosecond laser-assisted cataract surgery (FLACS): a randomised, controlled clinical trial.
Dzhaber D, Mustafa O, Alsaleh F, et al.
BRITISH JOURNAL OF OPHTHALMOLOGY
2020;104:225-9.