Comparison of the effect of AquaLase and NeoSoniX phacoemulsification on the corneal endothelium

Purpose

To compare the extent of corneal endothelial cell loss and pachymetry changes in 2 age-based groups of patients who had cataract removal by AquaLase (Alcon) phacoemulsification in 1 eye and NeoSoniX (Alcon) phacoemulsification in the contralateral eye.

Setting

Department of Ophthalmology, University Hospital, Hradec Králové, Czech Republic.

Methods

This prospective clinical study comprised 28 patients younger than 80 years (Group A) and 28 patients 80 years or older (Group B) with bilateral cataract having lens removal using AquaLase in the right eye and NeoSoniX in the left eye. The nuclei were graded clinically on the basis of hardness. The endothelial cell count (ECC), pachymetry, and best corrected visual acuity (BCVA) were evaluated preoperatively and postoperatively. The mean ECC and pachymetry values (±SD) were calculated in each group, with differences between right and left eyes analyzed using the paired t test.

Results

In Group A, the differences in the postoperative changes in ECC and pachymetry between AquaLase and NeoSoniX were not statistically significant. In Group B, there were statistically significant differences in postoperative changes in ECC and pachymetry, with the results better in the AquaLase eyes. The BCVA immediately after surgery was better than preoperatively in all eyes.

Conclusion

The results suggest that AquaLase cataract extraction is safe for the endothelium, even in older patients with harder cataracts and a lower ECC count preoperatively.