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Comparison of surgical parameters using different lens fragmentation patterns in eyes undergoing laser-assisted cataract surgery

Abstract

Purpose

To compare surgical parameters among eyes undergoing laser-assisted cataract surgery (LACS) using different lens fragmentation patterns (LFP).

Methods

Prospective, randomized, unmasked clinical trial. One-hundred eyes underwent LACS and were randomly assigned to 1 of 3 LFP treatment groups: (1) laser capsulotomy only; no lens fragmentation (NLF) (n = 34); (2) three-plane chop (TPC) (n = 33); and, (3) pie-cut pattern (PCP) fragmentation (n = 33). Prechop phacoemulsification (PHACO) was performed on all eyes using the same femtosecond (FS) laser and active-fluidics PHACO machine. Main outcome measures: FS laser dock time (s), PHACO time (s), PHACO power (%), cumulative dissipated energy (CDE) (%-s), irrigating fluid volume, and operative time.

Results

The 3 treatment groups were comparable in terms of patient age (P = 0.164) and nuclear density (P = 0.669). FS dock time was higher in the PCP group (184.18 ± 25.86) compared to the TPC (145.09 ± 14.15) group (P < 0.001). PHACO time was significantly shorter in the PCP (23.19 ± 17.20 s) compared to TPC (35.27 ± 17.70) and NLF (46.15 ± 23.72) groups (P < 0.001). PHACO power was lower in the PCP (11.81 ± 3.71) compared to the NLF (14.41 ± 1.88) and TPC (14.04 ± 2.46) groups (P < 0.001). CDE was lower in the PCP (2.85 ± 2.32) compared to NLF (6.55 ± 3.32) and TPC (6.55 ± 5.45) groups (P < 0.001). Fluid volumes and operative times were similar.

Conclusion

LFP can influence PHACO surgical parameters. Extensive fragmentation patterns such as PCP appear to lower PHACO time, power, and CDE and may potentially reduce the risk of PHACO related complications.

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Correspondence to Harvey S. Uy.

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Conflict of interest

Drs. Harvey S. Uy and Sunil Shah have received research grants from LENSAR, Inc. Dr. Raquel Gil-Cazorla has no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Uy, H.S., Chan, P.S., Gil-Cazorla, R. et al. Comparison of surgical parameters using different lens fragmentation patterns in eyes undergoing laser-assisted cataract surgery. Int Ophthalmol 39, 2459–2465 (2019). https://doi.org/10.1007/s10792-019-01087-8

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Keywords

  • Laser-assisted cataract surgery
  • LACS
  • Phacoemulsification
  • Lens fragmentation