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Toward the elimination of ultrasound with femtosecond laser cataract surgery

Session Details

Session Title: Femto-cataract

Session Date/Time: Monday 07/10/2013 | 08:00-10:00

Paper Time: 08:50

Venue: Forum (Ground Floor)

First Author: : J.Vukich USA

Co Author(s): :    I. Conrad Hengerer   F. Hengerer   T. Schultz   H. Dick     

Abstract Details

Purpose:

To compare the effect of femtosecond laser cataract surgery (LCS) on effective phacoemulsification time with various fragmentation patterns.

Setting:

Ruhr University Eye Clinic, Bochum, Germany

Methods:

A series of prospective clinical trials were conducted to assess effective phacoemulsification time (EPT) following capsulotomy and lens fragmentation with a laser for cataract surgery (Catalys Precision Laser System, OptiMedica, California USA). The patients were docked with a non-applanating Liquid Optics Interface. Surface maps were calculated from full volume 3D OCT images of the anterior segment through the posterior capsule. Fragmentation volume was maximized utilizing the maps and overlaying a 500 micrometer safety zone from the posterior capsule. A comparison of manual (n=52) and laser with a 500 micrometer grid spaced pattern (n=57) was conducted first. A second comparison was conducted comparing EPT between a 500 micrometer (n=80) and 350 micrometer (n=80) grid pattern. Preoperative nuclear opacity was estimated by one independent physician with a slitlamp and graded according to the LOCS III scale. Both groups underwent phacoemulsification using pulsed ultrasound energy.

Results:

In the first cohort, manual technique (Average LOCS III grade = 3.1±0.8, n=52) resulted in an EPT of 4.07±3.14. Lens removal followed by LCS pretreatment (n=52, average LOCS III grade = 3.4±0.9) with a 500 micrometer grid resulted in average EPT of 0.16±0.21. This is a 96% reduction in EPT. Reduction of grid spacing to 350 micrometers resulted in 86% reduction over the 500 micrometer grid pattern.

Conclusions:

The use of the femtosecond laser system to pretreat the nucleus led to 99% reduction in EPT over manual procedure. The potential advantages for the patient could include faster visual recovery, less corneal inflammation, reduced endothelial cell loss, and less zonular stress.

Financial Interest:

... has significant investment interest in a company producing, developing or supplying product or procedure presented