Corneal Protection in Cataract Surgery

Protection of the corneal endothelium is one of the most important aspects of cataract surgery. This thesis describes two studies that examine new products and techniques to protect the cornea in cataract surgery. The first study examines the corneal protective effect of a new viscoelastic, DisCoVisc, compared to two established products in a randomised control trial of 180 patients. While no objective difference in corneal protection could be found between DisCoVisc and the other two viscoelastics, DisCoVisc compared more favourably in subjective surgical behaviour when compared to Healon although no difference could be found when compared to Amvisc Plus. Complications during surgery have the potential to adversely affect the corneal endothelium. The second study is a retrospective analysis of 1589 cases of Femtosecond Laser Assisted Cataract Surgery (FLACS) using the LenSx femtosecond laser with the SoftFit patient interface. It found the rate of capsular complications using the LenSx femtosecond laser with the SoftFit patient interface was notably lower than published rates of capsular complications with manual phacoemulsification. It compares favourably with earlier studies using the LenSx platform as well as earlier studies using other femtosecond laser platforms. This study’s result is in disagreement with a meta-analysis published in 2016 which found a higher capsular complication rate with FLACS and is more in keeping with recent published studies of the safety of FLACS using the LenSx platform