Comparison Of Safety, Efficacy And Post-Operative Endothelial Cell Density Following Conventional Phacoemulsification Versus Femto-Laser Assisted Surgery With Customized Nuclear Fragmentation Patterns In Dense Cataracts

Comparison of safety, efficacy and post-operative endothelial cell density following standard phacoemulsification versus LENSAR  femtosecond laser assisted cataract surgery in dense cataracts ( LOCS grade 3 and above).

Nethradhama superspeciality eye hospital, Bangalore, India

100 eyes of 100 patients ( n=50 in each group) undergoing either  conventional phacoemulsification surgery or FLACS with LENSAR femtolaser system using pre-defined incorporated patterns of nuclear fragmentations were compared for intra-operative ultrasound time, aspirated fluid, total surgical time and complication rates between the two groups. The phaco machine used for both groups was the OERTLI phacoemulsification system (Oertli instruments AG, Switzerland). Endothelial cell density was evaluated at 6 months post-operatively.

The mean age, grade of cataract and endothelial cell density was matched between the two groups pre-operatively, p>0.05 for all parameters. Intra-operatively, the mean  ultrasound time (11.17 ± 6.5 sec) and  volume of the aspirated fluid (38.64 ± 13.73 ml) were significantly higher for the phaco group versus the FLACS group( ultrasound time 8.03 ± 3.77sec,aspirated fluid volume 33.9 ± 9.54ml), p<0.05. Post-operatively at 6 months, the endothelial cell density was significantly higher in the FLACS group (2250.16 ± 230.09 cells/mm²) when compared to the phaco group (2126.9 ± 355.6cells/mm²), p<0.05.

Femtolaser assisted cataract surgery with pre-defined nuclear fragmentation patterns customized for the cataract grade resulted in significantly less intra-operative phaco time, fluid utilized and improved endothelial cell density compared to conventional phacoemulsification while managing dense cataracts.