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Short-term effect of two cataract surgery methods: phacoemulsification and photofragmentation

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Session Details

Session Title: Evolution in FLACS & Phaco Technology

Session Date/Time: Sunday 23/09/2018 | 08:00-09:45

Paper Time: 09:14

Venue: Room A3, Podium 2

First Author: : G.Sauder GERMANY

Co Author(s): :    P. Mattei                    

Abstract Details


To evaluate short-term (1-7 days postoperative) endothelial cell counts following cataract surgery using either ultrasound (US) phacoemulsification or nanolaser photofragmentation.


Department of Ophthalmology, Charlottenklinik, Stuttgart, Germany


Fifty-eight consecutive patients were enrolled in this prospective, randomized, double-masked, clinical interventional study. The inclusion criteria were age between 60 and 75 years, and nuclear cataract of grade 3 (Lens Opacities Classification System III). Patients were randomly assigned to one of two groups: Phaco-Group underwent cataract surgery using phacoemulsification performed with a Centurion Vision System (Alcon) and Nano-Group using the same system replacing the hand-piece with the Cetus Nanolaser system (A.R.C. Laser). Both the patient and the ophthalmologist who performed post-operative visits were blinded to grouping. The main outcome measures were 1 and 7 days corneal endothelial cell counts (cells/mm2).


The two groups did not present statistically significant differences for sex, age, eye or cataract grade. All procedures were uneventful. A statistically significant greater amount of mean energy was used in the Phaco-Group (p<0.001). A statistically significant greater amount of balanced salt solution was required to complete the procedures in the Nano-Group (p=0.018). The decrease endothelial cell counts observed in the two Groups were not statistically significant at one day post-operatively. At seven days post-operatively, the average endothelial cell count continued to decrease for the Phaco-Group but increase for the Nano-Group. This difference was statistically significant (p=0.007).


Although the nanosecond laser assisted cataract procedures required more fluidics, they were effectively completed requiring a significantly lower energy consumption. It also yielded a significantly higher corneal endothelial cell count after seen days, thus indicating a significant reduction in tissue trauma with photofragmentation compared to phacoemulsification.

Financial Disclosure:


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