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Am J Ophthalmol. 2014 Feb;157(2):426-432.e1. doi: 10.1016/j.ajo.2013.09.017. Epub 2013 Nov 7.

Impact of crystalline lens opacification on effective phacoemulsification time in femtosecond laser-assisted cataract surgery.

Author information

1
Department of Ophthalmology, Goethe-University Frankfurt am Main, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany; Department of Ophthalmology, Ludwig-Maximilians-University Munich, Mathildenstrasse 8, 80336 Munich, Germany.
2
Department of Ophthalmology, Goethe-University Frankfurt am Main, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany.
3
Department of Ophthalmology, Goethe-University Frankfurt am Main, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany. Electronic address: kohnen@em.uni-frankfurt.de.

Erratum in

  • Am J Ophthalmol. 2014 Apr;157(4):920.

Abstract

PURPOSE:

To compare effective phacoemulsification time in cataract surgery performed by manual phacoemulsification vs femtosecond laser-assisted lens fragmentation.

DESIGN:

Retrospective, consecutive, nonrandomized, comparative case series.

METHODS:

The setting was the Department of Ophthalmology, Goethe-University, Frankfurt, Germany. The study population included 150 eyes of 86 patients with senile cataract. In the intervention, 88 eyes (group 1) underwent femtosecond laser-assisted surgery (corneal incisions, capsulotomy, lens fragmentation) using the LenSx platform (Alcon) and residual lens work-up with pulsed ultrasound energy (Infiniti Vision System; Alcon). In 62 eyes (group 2), complete cataract removal was performed with phacoemulsification only, using pulsed ultrasound energy with the same device (Infiniti). Nucleus staging (Pentacam nucleus staging; PNS) was evaluated using Pentacam HR (Oculus); endothelial cell density was measured using specular microscopy (NonCon Robo). The main outcome measures were as follows. Mean preoperative PNS staging was assessed using an automatic ordinal scaling (PNS-O, grades 0-5) and a manually defined density grid derived from Scheimpflug imaging (PNS-P [%]). Effective phacoemulsification time and endothelial cell loss were evaluated in both groups.

RESULTS:

Preoperative PNS-O and PNS-P showed no significant difference between groups (P = 0.267). Overall mean effective phacoemulsification time was significantly lower in group 1 (1.58 ± 1.02 seconds) compared to 4.17 ± 2.06 seconds in group 2 (P = 0.001). Effective phacoemulsification time was significantly lower in group 1 for all PNS-O stages (P < 0.001). With increasing preoperative PNS-P, effective phacoemulsification time increased in both groups; however, this gain was noticeably, but not significantly, lower in group 2. Endothelial cell loss was significantly lower in group 1 (P = 0.02).

CONCLUSIONS:

Femtosecond laser-assisted cataract surgery allows a significant reduction in effective phacoemulsification time, which correlates positively with the preoperative lens opacity.

PMID:
24210764
DOI:
10.1016/j.ajo.2013.09.017
[Indexed for MEDLINE]

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