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

Abstract

Purpose

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

Acknowledgments

The authors wish to thank Gerard Smits PhD for assistance with statistical analysis, the staff members at the clinical sites, and the staff at CIARC for their diligent support of this study.

Disclosure

TS reports no conflict of interest in this work. MCV is a consultant for Centricity Vision Inc., outside the submitted work. Dr KYJ reports personal fees from Centricity Vision Inc. during the conduct of the study. DS is a founder of and has financial interest in Centricity Vision Inc. In addition, DS has a patent on a capsulotomy ring design issued to owned by Centricity Vision Inc.