Clinical Ophthalmology (Jun 2023)

Endothelial Cell Loss Following Cataract Surgery Using Continuous Curvilinear Capsulorhexis or Precision Pulse Capsulotomy

  • Vital MC,
  • Jong KY,
  • Trinh CE,
  • Starck T,
  • Sretavan D

Journal volume & issue
Vol. Volume 17
pp. 1701 – 1708

Abstract

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Mark C Vital,1 Kevin Y Jong,1 Clarise E Trinh,1 Tomy Starck,2 David Sretavan3 1Houston Eye Associates, Houston, TX, USA; 2UltraVision, San Antonio, TX, USA; 3Centricity Vision Inc., Carlsbad, CA, USACorrespondence: Mark C Vital, Houston Eye Associates, 2855 Gramercy Street, Houston, TX, 77025, USA, Tel +1 713 668 6828, Fax +1 832 553-7154, Email [email protected]: To compare endothelial cell density (ECD), percentage of hexagonal cells (%Hex) and coefficient of variation (CV) in cell size following lens cataract surgery with phacoemulsification performed using Continuous Curvilinear Capsulorhexis (CCC) or Precision Pulse Capsulotomy (PPC).Patients and Methods: Sixty-seven subjects were randomly assigned to undergo lens cataract removal with the capsulotomy step performed using either CCC or PPC. Specular microscopy images were obtained pre-operatively, 1 month and 3 months after surgery. ECD, %Hex and CV were analyzed in a masked fashion by an independent reading center.Results: The mean percentage ECD loss at 1 month was 11.5% in the CCC group and 12.3% in the PPC group (P = 0.818; t-test). At 3 months, the mean percentage ECD loss was 11.7% in the CCC group and 12.4% in the PPC group (P = 0.815; t-test). The mean %Hex at 1 month was 54.3% in the CCC group and 54.7% in the PPC group (P = 0.695; t-test). At 3 months, the mean %Hex was 56.2% in the CCC group and 54.7% in the PPC group (P = 0.278; t-test). The CV at 1 month was 34.4% in the CCC group and 34.3% in the PPC group (P = 0.927; t-test). At 3 months, the CV was 32.7% in the CCC group and 33.4% in the PPC group (P = 0.864; t-test).Conclusion: No differences in ECD loss, %Hex and CV were observed between patients who received CCC or PPC. PPC use during cataract surgery does not result in any increased endothelial cell loss beyond that normally associated with this surgery.Keywords: automated capsulotomy, zepto, corneal endothelium

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