Posters

Tips and tricks for using at its highest potential the FemtoLaser technology in challenging cataract cases

Poster Details

First Author: O.Moraru ROMANIA

Co Author(s):    C. Moraru   M. Iliescu                 

Abstract Details

Purpose:

To present the true benefits of the FemtoLaser technology, obtained by adjusting the Laser parameters, fragmentation pattern and surgical technique, in challenging cataract cases, where it really makes the difference. We followed case series of hard-rock cataract, white intumescent cataract, posterior polar cataract and small pupil cases.

Setting:

Oculus Eye Clinic – Bucharest, Romania

Methods:

We considered four case series of hard-rock cataract, white intumescent cataract, small pupil eyes and posterior polar cataract and, all performed with FemtoLaser and four similar series performed with standard phacoemulsification by chop technique. Then, we divided each of the four FemtoLaser categories in two groups, depending on the Laser settings (higher versus lower energy) and fragmentation pattern (number of fragments). We compared the efficacy, in terms of ultrasound energy used and surgery duration (measured from the first paracentesis, up to the last fragment removal) and the complication rate, between the three groups, on each of the four categories.

Results:

In terms of surgery time and ultrasound energy used, there were no significant differences in any of the four categories, when compared the chop-phacoemulsification eyes and their corresponding eyes done with “standard settings” FemtoLaser, although the femtolaser fragmentation allows for less risks during the subsequent phacoemulsification part of surgery, in all these categories of challenging cataracts. However, the FemtoLaser eyes performed with “adjusted” laser settings and fragmentation pattern showed higher efficacy and lower complication rate, compared with both “standard-settings” FemtoLaser eyes and phacoemulsification eyes.

Conclusions:

The FemtoLaser technology ensures a lower risk for complications in challenging eyes: the lower ultrasound energy used in hard cataracts brings benefit for corneal endothelium and postoperative inflammation, the accurate capsulorhexis is less prone to run-out in white cataracts, the pre-cut nucleus in small pupils avoids the need to dangerously insert the chopper in a blind zone and the nucleus fragmentation in several pieces totally avoids the need for hydrodissection-delineation and rotation in posterior polar cataracts. Moreover, adjusting the laser parameters, the fragmentation pattern and the surgical technique offers a shorter and more “eye tissue friendly” surgery in these cases.

Financial Disclosure:

None