Posters

Evolution and current limits in nanolaser photofragmentation cataract surgery

Poster Details

First Author: G.Sauder GERMANY

Co Author(s):    M. Braun   S. Moedl                 

Abstract Details

Purpose:

To compare the limitations (cataract grade and comorbidities) and requirements (incision size, time, energy, and fluidics) for cataract surgery using either ultrasound (US) phacoemulsification or nanolaser photofragmentation for cataract removal.

Setting:

Charlottenklinik für Augenheilkunde in Stuttgart, Germany

Methods:

This study is a retrospective evaluation of over 15 years of experience with both phacoemulsification with a Centurion Phaco (Alcon) with Active Fluidics Technology and photofragmentation with a Cetus Nanolaser system (A.R.C. Laser) and principally Active Fluidics Technology for irrigation/aspiration, with over 5,000 patients successfully completed with the three versions of the latter. Time, energy and fluidics required and conversion rate were assessed as intraoperative parameters. Corneal thickening and corneal endothelial cell counts were assessed as post-operative. Patient satisfaction was also assessed using the National Eye Institute Refractive Quality of Live questionnaire.

Results:

The most recently released version of the photofragmentation handpiece provided a significant improvement in fluid management and cataract fragment holdability. Intraoperative parameters for the two techniques are now comparable. Photofragmentation still has a conversion rate to phacoemulsification under 1%. This occurs in patients were extremely hard cataracts were encountered. Photofragmentation yielded significant improvements in terms of reducing the time require to achieve best uncorrected visual acuity and remission of corneal thickening and endothelial cell sparing. Patient satisfaction was also significantly better for this technique.

Conclusions:

Currently, the limits for photofragmentation are similar to those for phacoemulsification. Patients whose procedures are delayed when phacoemulsification was the only option, such as low corneal endothelial cell count, now have another option. Photofragmentation may be more feasible option for clear lens extraction.

Financial Disclosure:

None