Journal List > J Korean Ophthalmol Soc > v.57(2) > 1010501

Ahn, Han, and Lee: Comparison of Effective Phacoemulsification Time between Femtosecond Laser-Assisted Cataract Surgery and Conventional Cataract Surgery

Abstract

Purpose

To compare the effect of femtosecond laser-assisted cataract surgery with conventional cataract surgery on effective phacoemulsification time (EPT).

Methods

This study included 66 patients 100 eyes who underwent femtosecond laser-assisted cataract surgery and 68 patients 100 eyes who underwent conventional cataract surgery. Both groups underwent phacoemulsification using pulsed ultrasound energy and EPT was evaluated. The groups were further analyzed according to preoperative Lens opacities classification system (LOCS) III grading. Patients who had femtosecond laser-assisted cataract surgery underwent lens fragmentation with quadrant, hybrid, or grid pattern and the EPT was respectively evaluated.

Results

The mean EPT was 5.85 ± 4.31 seconds in the femtosecond laser-assisted cataract surgery group and 10.34 ± 6.61 seconds in the conventional group. Overall, EPT was statistically significantly lower in the femtosecond laser-assisted cataract surgery group compared to the conventional group. When the groups were analyzed according to LOCS III grading, this result was consistent for all cataract grades and the reduction in EPT was increased with the higher LOCS III grade. When the groups were analyzed according to lens fragmentation patterns, the mean EPT was lower with 350 μm grid pattern than the quadrant or hybrid pattern.

Conclusions

The femtosecond laser-assisted system in cataract surgery can be an efficient cataract surgery using lower EPT compared to the conventional procedure. Additionally, significant differences were observed in the mean EPT of cataract surgery using the femtosecond laser-assisted system among the 3 lens fragmentation pattern groups.

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Figure 1.
Fragmentation pattern during cataract surgery. (A) Quadrant pattern, (B) hybrid pattern, and (C) grid pattern. LenSx real-time imaging showing planned capsulotomy (pink circle) and lens fragmentation (yellow line). N/A = not avail-able; cyl = cylinder; dgr = degree; CCW = counterclockwise.
jkos-57-236f1.tif
Figure 2.
Effective phacoemulsification time comparison between femtosecond laser-assisted cataract surgery (femtosecond) group and conventional cataract surgery group. Student's t-test was used to examine statistical difference.
jkos-57-236f2.tif
Figure 3.
Effective phacoemulsification time in the femtosecond group and conventional group in regard to the nuclear opacity (LOCS III). Student's t-test was used to examine statistical difference. NO = nuclear opacity by LOCS III classification.
jkos-57-236f3.tif
Figure 4.
Effective Phacoemulsification Time comparison of different lens fragmentation in the femtosecond group. Kruskal-Wallis test was used to examine statistical difference. * Significant difference between groups.
jkos-57-236f4.tif
Table 1.
Demographics of patients
Characteristic Femtosecond group Conventional group p-value
Number of eyes (patients) 100 (66) 100 (68) 0.851
Age (years) 64.57 ± 12.86 62.25 ± 13.37 0.787
Sex (male:female) 38:28 32:36 0.576
NO 3.24 ± 0.94 3.17 ± 0.90 0.645
BCVA (log MAR) 0.78 ± 0.36 0.81 ± 0.27 0.333
Axial length (mm) 24.43 ± 1.67 23.87 ± 1.02 0.333
Endothelial cell density (cell/mm2) 2,521.71 ± 287.80 2,503.13 ± 261.73 0.725

Values are presented as mean ± SD unless otherwise indicated.

NO = nuclear opacity by Lens opacities classification system (LOCS) III classification; BCVA = best corrected visual acuity.

Table 2.
Preoperative slit-lamp microscopy evaluation of nuclear opacity by LOCS III
LOCS III Eyes (n)
Femtosecond group Conventional group
NO2 18 20
NO3 42 38
NO4/4+ 40 42

NO = nuclear opacity by LOCS III classification; LOCS III = Lens opacities classification system.

Table 3.
Effective phacoemulsification time in the femtosecond group and conventional group in regard to the nuclear opacity by LOCS III
LOCS III Effective phacoemulsification time (s)
Femtosecond group Conventional group p-value*
NO2 2.21 ± 1.82 5.03 ± 3.18 0.000
NO3 6.15 ± 3.87 10.38 ± 4.33 0.019
NO4/4+ 7.85 ± 4.33 13.09 ± 6.55 0.043

Values are presented as mean ± SD unless otherwise indicated.

LOCS III = Lens opacities classification system; NO = nuclear opacity by LOCS III classification.

* Tested by Student's t-test (p < 0.05: statistically significant p-value).

Table 4.
EPT comparison of different lens fragmentation in the femtosecond group
Quadrant Hybrid Grid p-value*
EPT (s) 5.54 ± 3.52 5.49 ± 3.14 1.82 ± 2.73 0.000

Values are presented as mean ± SD unless otherwise indicated.

EPT = effective phacoemulsification time.

* Tested by Kruskal-Wallis test (p < 0.05: statistically significant p-value).

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