Nanolaser Versus Phakoemulsifikation: Comparison Of Different Handpieces

To compare the recent version of handpieces  of Nanolaser in cataract surgery versus phakoemulsifikation in terms of fluidics, energy, effective photofragmentation/ phakoemulsifikation time (EPT) and same day best corrected distance visual acuity

Charloottenklinik für Augenheilkunde, Stuttgart, Germany

The first 34 patients of each nanolaser handpiece, scheduled for routine cataract surgery were retrospectively enrolled. They have also been compared with a phakoemulsifikation control group. The Cetus™ nanolaser (A.R.C. Nuernberg, Germany) was used in the four nanolaser groups and the Centurion® phakoemulsifikation machine (Alcon, Fort Worth,TX) in the phako group. All surgeries have been performed by one surgeon. There were no statistically significant differences in gender, density of cataract, preoperative visual acuity and intraocular pressure. Exclusion criteria were intraocular pathologies that would have hindered the objective of emmetropia for distance vision.

All four nanolaser handpieces required significantly lower mean energy compared to cataract surgery reaching 1/12 for the fourth nanolaser handpiece. The two last versions of nanolaser handpieces did not require a significantly greater amount of fluidics or longer PET than phako. The percentage of endothelial cell loss decreased with the newer version with the smallest gain with the last version, reaching 1/3 of that with phakoemulsifikation. While the five groups did not have a statistically significant difference in frequency of patients with 0.2 logMAR or better, pooling four nanolaser groups was statistically different (113/136 (83.08%) vs 19/34 (55.88%). Fisher´s exact test, p=.0194)

The fourth generation of nanolaser handpiece showed comparable results to phakoemulsifikation in terms of fluidics and EPT while requiring a significantly lower amount of energy and greater endothelial cell sparing. Moreover, nanolaser resulted in a significantly higher number of patients seeing 0.2logMAR or better immediately after surgery