Nanolaser Cataract Surgery: A 5 Year Follow Up Retrospective Study

Published 2025 - 43rd Congress of the ESCRS

Reference: PP04.05 | Type: Free paper | DOI: 10.82333/65bx-cq54

Authors: Detlev R.H. Breyer ¹ , Mücella Kirca ² , Lena Beckers ³ , David Beckers* ³ , Kristin-Lena Artz ² , Florian Kretz ⁴ , Gerd Auffarth ⁵

¹Internationale Innovative Ophthalmochirurgie,Breyer-Kaymak-Klabe Eye Surgery and Premium Eyes,Düsseldorf,Germany;International Vision Correction Research Center Network (IVCRC.net),Heidelberg,Germany, ²Internationale Innovative Ophthalmochirurgie,Breyer-Kaymak-Klabe Eye Surgery and Premium Eyes,Düsseldorf,Germany, ³Precise Vision Augenärzte ,Rheine,Germany;Internationale Innovative Ophthalmochirurgie,Breyer-Kaymak-Klabe Eye Surgery and Premium Eyes,Düsseldorf,Germany, ⁴Precise Vision Augenärzte ,Rheine,Germany;International Vision Correction Research Center Network (IVCRC.net),Heidelberg,Germany, ⁵Augenklinik,Universitätsklinikum Heidelberg,Heidelberg,Germany;International Vision Correction Research Center Network (IVCRC.net),Heidelberg,Germany

Purpose

To show the advantages of NanoLaser Cataract Surgery in the long run: Preserving endothelial condition in cataract surgery through adequate surgical technology results in better endothelial survival compared to standard surgery in the long run. Patients undergoing low energy and ultrasound free cataract surgery profit from a significant better endothelial survival after cataract surgery and less complications afterwards.

Setting

Eye Center Hildesheim-Alfeld. Cataract surgery was performed as an outpatient treatment with predominantly topical anesthesia.

Methods

We used the Nano Laser system (CETUS, A.R.C. Laser) to operate patients with a demand for non-traumatic cataract surgery and best visual results. We compared published data from standard ultrasound operated patients with the Nano Laser operated patients on endothelial cell loss after 5 years. In the Nano Laser treated patients we also used a pre chop device (Akahoshi Combo 2 Chopper) and a Soft Shell technique (Arshinoff).

Endothelial cell counts were measured with a Nidek device (CEM-530). Energy Input Datas were derived by the Cetus device (A.R.C. Laser)

Results

After 5 years of post surgery surveillance, we had 30 eyes from 15 female and 15 male patients in continuous control. The age was median 71 years ( 55 – 81 Years). The preoperative endothelial cell counts (ranged from 1557 c/mm2 to 2936 c/mm2) in median were 2290 c/mm2. The post OP endothelial cell counts after 5 years were 2018,4 c/mm2 ( ranged from 1316 – 2629 c/mm2). The overall procentual cell loss was 11,8 % after 5 years ( Range 0.5 – 35 %) . The energy input ranged from 915 mJ to 7.5 Joule (Median 3,27 J). A correlation to energy input and endothelial cell loss was obvious.

Conclusions

With the adequate combination of endothelial sparing techniques (NanoLaser, Pre Chop, SoftShell) the endothelial cell loss of the patients after cataract surgery was lesser ( 11,8 %) compared to patients receiving standard Ultrasound surgery (15 – 25 % (Studies by Armitage et al., Storr-Paulsen et al., Walkow et al., Hayashi et al.)).