Are harder cataracts still a limit for nanolaser cataract surgery?

Session Details

Session Title: Presented Poster Session: Cataract Complications & Special Cases

Venue: Poster Village: Pod 1

First Author: : G.Sauder GERMANY

Co Author(s): :    P. Mattei                       

Abstract Details

Purpose:

To evaluate if cataract with a Lens Opacities Classification System III (LOCS III) of grade 4 are an exclusion criterion for nanosecond laser cataract removal.

Setting:

Department of Ophthalmology, Charlottenklinik, Stuttgart, Germany

Methods:

The first 21 consecutive patients age-related cataract, primary hyperopia, or hyperopic astigmatism who presented a normal ophthalmologic examination except senile cataract who underwent cataract surgery after the introduction of the third-generation hand-piece for the Cetus Nanolaser system (ARC Laser, Nürnberg, Germany). The major improvement in the handpiece was a decrease of the quartz fiber optic diameter from 320 μm to 270 μm while maintaining an inner bore of 720 μm and the outer bore of 1000 μm. The irrigation and aspiration compartments were also separated within the hand-piece. Overall, these modifications increased the crystalline material acquisition power during photofragmentation.

Results:

The patients ranged in age from 59 to 90 years old. Based on the results obtained with previous nanolaser hand‑pieces in patients with cataract classified as harder than LOCS III grade 4, None of the procedures were expected to be successfully completed with nanolaser alone. The results obtained (i.e., all 21 successfully completed without conversion to phacoemulsification) indicated a highly significant (p<0.0001; Fisher exact test) improvement in the efficacy of nanolaser cataract surgery for removing grade 4 cataracts. Patients without retinal pathology obtained a significant improvement in best uncorrected distant vision within 15 days. Complications were not reported.

Conclusions:

Harder grade 4 cataracts should no longer be considered an exclusion criterion for the use of a nanosecond laser in cataract surgery. Further studies are required to determine if the reduced quantity of energy emitted within eyes during surgery when using a nanolaser system compared with an ultrasound system will effectively improve long‑term outcome in these harder cataracts.

Financial Disclosure:

None