Corneal refractive and endothelial changes following THC:YAG (holmium) laser sclerostomy.
BACKGROUND AND OBJECTIVE: To determine the effect of THC:YAG (holmium) laser sclerostomy on corneal curvature and endothelial cell counts. PATIENTS AND METHODS: One hundred twenty-five cases were reviewed for high postoperative corneal astigmatism (> 5 D) or preoperative and postoperative endothelial cell count measurements in eyes without preoperative evidence of corneal endothelial compromise. RESULTS: Nine patients had keratometry reading at 2 to 3 months with documented corneal astigmatic changes of 5.62 to 12 D (mean 7.27 +/- 2.16 D). Sixteen eyes of 14 patients studied with specular microscopy had central mean endothelial cell count reductions of 6.5% following THC:YAG laser sclerostomy. The total energy applied correlated with the percentage reduction in endothelial cell counts (r = .507, P = .045, n = 16, Spearman correlation). CONCLUSION: Higher laser energy levels can result in high corneal astigmatism, which in some cases may be persistent, and a reduction in endothelial cell count.