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Results of laser cataract extraction with Nd-YAG 1.44 mcm
Session Title: Phaco Techniques
Session Date/Time: Saturday 05/10/2013 | 08:30-10:30
Paper Time: 10:02
Venue: Main Lecture Hall (Ground Floor)
First Author: : V.Kopayeva RUSSIA
Co Author(s): : S. Kopayev, A. Sagorulko E. Leksutkina V. Starostin O. Kravchuk
To present an evaluation of Laser Cataract Extraction (LCE) in 4 clinics using a Russian technique developed under the guidance of Prof. S.N. Fyodorov
Fyodorov Eye Microsurgery State Institution, Moscow1 and the Branches in Sankt-Pitersburg2, Krasnodar³, Ulyanovsk ZKB4, Russia.
Last year 1300 operations LCE ( total quantity LCE 10532) was carried out in patients aged 60-94 years with immature cataracts (27%), with medium cataracts - (48%), with hard and very hard cataracts - (25%). Hard cataracts were noted most frequently in the age over 72 years. Russian device RACOT was used . Parameters: solid state Nd:YAG laser; wavelength - 1.44 µm; repetition rate -30 Hz; energy per pulse - 250 mJ ; forevacuum pump. Surgical technique: bimanual. Working laser duration: several sec. - 5 min., depending on the nucleus hardness.
Nuclei of any hardness were crushed spontaneously under the radiation effect without manual fragmentation, without ultrasound energy. Cataracts with lens subluxation, 10°- 90° ciliary zonule abruptions were successfully extracted in 2 %. Intraoperatively 10 posterior capsule ruptures (0.8%) were noted during the removal of fibrotic opacities from its surface in immature cataracts. Areactive course was observed in 1283 cases (98.7%) postoperatively. Reactive transitory hypertension: 12 eyes (0.9%). Corneal edema - 5 (0.4%). Visual acuity achieved a maximum level after 5-7 days. Endothelial cell loss: immature cataracts - 0.5-2%, hard and brunescent cataracts - 4-6%.
The Russian LCE technique using Nd-YAG laser 1.44 µm allows to crush nuclei of any hardness. The operation can be successfully performed in case of zonula ciliaris abruption up to 120° because there is no pressure on nucleus. The quantity of complications and the endothelial cell loss are minimum.