Femtosecond Laser-Assisted Cataract Surgery: Effective and Average Phaco Time and Endothelial Cell Loss in Contralateral Comparative Study

Auffarth, Gerd

Femtosecond Laser-Assisted Cataract Surgery: Effective and Average Phaco Time and Endothelial Cell Loss in Contralateral Comparative Study

Friday, April 25, 2014

KIOSKS (Boston Convention and Exhibition Center)

Gerd U. Auffarth, MD, David J Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre, University of Heidelberg, Heidelberg, Germany

Ramin Khoramnia, MD, David J Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany

Anna Fitting, MSc, University of Heidelberg, Heidelberg, Germany

Mary Safwat Aziz Attia, MD, University Clinic, Heidelberg, Heidelberg, Germany

Florian N. Auerbach, MD, University Hospital Heidelberg, Heidelberg, Baden-Wuerttembe, Germany

Mike P. Holzer, MD, University of Heidelberg, Heidelberg, Germany

Narrative Responses:

Purpose
To compare femtosecond laser cataract surgery with conventional surgery (manual continuous curvilinear capsulorhexis and phacoemulsification) in terms of effective phacotime (EPT), average phacotime (APT) and endothelial cell loss.

Methods
Evaluation of two cataract surgery methods on 30 patients in course of a prospective, contralateral, comparative, randomized, single-center study. On one eye of each patient capsulotomy and lens fragmentation is performed with the Victus Femtosecond Laser Platform (Bausch&Lomb/Technolas Perfect Vision). On the other eye capsulorhexis is accomplished manually and standard phacoemulsification is performed. For the phacoemulsification a Stellaris system (Bausch&Lomb) is used. Amongst the main outcome measures were EPT, APT and endothelial cell loss, measured with a non-contact endothelial microscopy (Tomey EM 3000 Specular Microscope) preoperatively, one month and six months after surgery.

Results
So far 17 patients with a median age of 73 years (range: 45-82 years) have been included in the study. Median EPT was statistically significantly lower (0.59 vs. 1.76 seconds) and showed less variation in the femtosecond laser group compared to the manually performed surgeries. A statistically significant difference between both groups in terms of APT (5.65 vs. 12.77 seconds) was found. The median endothelial cell loss was 3.7% one month postoperatively and 11.2% six months postoperatively in the femtosecond laser group and 12% and 16.5%, respectively, in the manual group.

Conclusion
Cataract surgery with the femtosecond laser reduces effective and average phacotime significantly. The initial results indicate less endothelial cell loss in the femtosecond laser group compared to the manual group. This could be a benefit especially in patients with low endothelial cell count preoperatively.