Comparison of surgical parameters using different lens fragmentation patterns in eyes undergoing laser-assisted cataract surgery
- 110 Downloads
To compare surgical parameters among eyes undergoing laser-assisted cataract surgery (LACS) using different lens fragmentation patterns (LFP).
Prospective, randomized, unmasked clinical trial. One-hundred eyes underwent LACS and were randomly assigned to 1 of 3 LFP treatment groups: (1) laser capsulotomy only; no lens fragmentation (NLF) (n = 34); (2) three-plane chop (TPC) (n = 33); and, (3) pie-cut pattern (PCP) fragmentation (n = 33). Prechop phacoemulsification (PHACO) was performed on all eyes using the same femtosecond (FS) laser and active-fluidics PHACO machine. Main outcome measures: FS laser dock time (s), PHACO time (s), PHACO power (%), cumulative dissipated energy (CDE) (%-s), irrigating fluid volume, and operative time.
The 3 treatment groups were comparable in terms of patient age (P = 0.164) and nuclear density (P = 0.669). FS dock time was higher in the PCP group (184.18 ± 25.86) compared to the TPC (145.09 ± 14.15) group (P < 0.001). PHACO time was significantly shorter in the PCP (23.19 ± 17.20 s) compared to TPC (35.27 ± 17.70) and NLF (46.15 ± 23.72) groups (P < 0.001). PHACO power was lower in the PCP (11.81 ± 3.71) compared to the NLF (14.41 ± 1.88) and TPC (14.04 ± 2.46) groups (P < 0.001). CDE was lower in the PCP (2.85 ± 2.32) compared to NLF (6.55 ± 3.32) and TPC (6.55 ± 5.45) groups (P < 0.001). Fluid volumes and operative times were similar.
LFP can influence PHACO surgical parameters. Extensive fragmentation patterns such as PCP appear to lower PHACO time, power, and CDE and may potentially reduce the risk of PHACO related complications.
KeywordsLaser-assisted cataract surgery LACS Phacoemulsification Lens fragmentation
Compliance with ethical standards
Conflict of interest
Drs. Harvey S. Uy and Sunil Shah have received research grants from LENSAR, Inc. Dr. Raquel Gil-Cazorla has no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 12.Reepolmaha S, Limtrakarn W, Uthaisang-Tanechpongtamb W, Dechaumphai P (2010) Fluid temperature at the corneal endothelium during phacoemulsification: comparison of an ophthalmic viscosurgical device and balanced salt solution using the finite element method. Ophthalmic Res 43:173–178PubMedGoogle Scholar
- 18.Dodick JM, Christiansen J (1991) Experimental studies on the development and propagation of shock waves created by the interaction of short Nd:YAG laser pulses with a titanium target. Possible implications for Nd:YAG laser phacolysis of the cataractous human lens. J Cataract Refract Surg 17:794–797PubMedGoogle Scholar
- 27.Frey RW, Edwards K, Naranjo Tackman R, Villar Kuri J, Quezada N, Bunch T, Bott S (2010) Changes in CDE with laser lens fragmentation compared with standard phacoemulsification cataract surgery. Investig Ophthalmol Vis Sci 51:5418Google Scholar