Akademik Veri Yönetim Sistemi
38th Congrees of Society of Cataract And Refractive Surgeons , Amsterdam, Hollanda, 2 - 04 Ekim 2020, ss.77-78
Purpose:
To investigate whether femto-lasik surgery causes inflammation in the anterior
chamber and its effect on endothelial cell density
Setting:
Department of Ophthalmology Istanbul University, Istanbul Faculty of Medicine,,
Istanbul, Turkey
Methods:
38 eyes of 19 patients who underwent femtosecond assisted lasik surgery due to
myopia and/or myopic astigmatism were included in our prospective clinical
study. All patients underwent preoperative complete ophthalmologic examination,
manifest and cycloplegic refraction values were recorded. Endothelial density
was measured withspecular microscopy and anterior chamber flare count was
measured by Laser Flare Photometry. Refractive surgeries were performed with
iFS™ Advanced Femtosecond Laser System and VISX STAR S4 IR Wavescan Excimer
Laser. Complete ophthalmological examination and flare measurements were
performed on the postoperative 1st day, 7th day, 1st month and 3rd month.
Endothelium count was repeated at 3rd month.
Results:
Uncorrected visual acuity (UCVA) increased from pre-op 1.18 ± 0.44 logMAR to
post-op -0.005 ± 0.07 logMAR. (p=0.0001) While the pre-op spherical equivalent
(SE) was -2.88 ± 2.49 diopters (D), this dropped to -0.22 ± 0.26 D postop.
(p<0.0001) Pre-op mean central corneal thickness (CCT) was 561.3 ± 31.1
microns and mean ablation amount was 62.29 ± 24.06 microns. While the pre-op
flare was 5.32 ± 1.01 photons / ms, it was 5.54 ± 1.62 photons/ms on the first
day, 5.72 ± 2.27 photons/ms on day 7, 5.65 ± 3,72 photons/ms in the first month
and 5,95 ± 1,73 photons / ms in the third month. There was no significant
difference in flare counts between pre-op and 1st day (p = 0.411), 7th day (p =
0.309), 1st month (p = 0.594) and in cross comparisons. A statistically
significant but minimal difference was observed between the pre-op flare count
and only the third month value. (p=0.05) While pre-op endothelium density was
2858.9 ± 249.4 cells / mm2, it decreased to a mean value of 2767 ± 243.4 cells
/ mm2 in the third post op month, with a mean decrease of 91 ± 237.9 cells /
mm2 . This difference was observed to be statistically significant. (p=0.024).
In Pearson correlation and linear regression analysis; there was a negative,
mild-moderate, statistically significant relationship between the decrease in
the count of endothelial cells and pre-op cylindrical refractive error. (R =
-0.381, p = 0.009) And no relationship was found with age, gender, pre-op
spherical, SE values and ablation amount. There was no relationship between
pre-op, 1st day, 7th day, 1st month flare values and other parameters, whereas
there was a weak but statistically significant relationship between 3rd month
flare value and pre-op spherical (R = 0.308, p = 0.03) and SE (R = 0.269, p =
0.05). When flare values were analyzed among themselves, no correlation was
detected.
Conclusions:
According to the present study, femto-lasik excimer laser does not cause
serious inflammation in the anterior chamber and does not increase the amount
of flare. To the best of our knowledge, this is the first study to evaluate
anterior chamber inflammation using flare count measurements in femto-lasik
refractive surgery. In addition, according to our limited number of cases, it
was observed that it caused a statistically significant but clinically
insignificant decrease in endothelial cell density.