Clinical Evaluation of Disposable Probe Nanosecond Laser–Assisted Clear Cornea Cataract Extraction

Sunday, April 19, 2015: 1:26 PM
Room 5B (San Diego Convention Center)
Bernd Kamppeter, MD
A. John Kanellopoulos, MD

To evaluate safety and efficacy of a novel surgical technique in small incision clear cornea cataract surgery.

In this clinical study, 178 successive patients (83 male, 95 female) were included to compare nanosecond-laser–assisted (group A) versus manual phacoemulsification cataract surgery (group B).  89 eyes were treated with nanosecond-laser and 89 eyes received ultrasound phacoemulsification.  The consumption of irrigation fluid, duration and energy of phacoemulsification  and laser pulse rate and total energy were evaluated. Furthermore, corneal edema and Descemet’s membrane folds and cornea edema were measured at postoperative day one using an arbitrary scale ranging from 0 to 4 (0= no folds and no edema, 4=dense folds and significant edema obscuring iris detail).

Mean energy: Group A; 4.8 Joules (+/- 2.5), average 148 laser pulses (+/- 117). Group B:  13.4 Joules ± 3.4. Fluid consumption, was respectively for Group A compared to Group B: Capsulorrhexis (1.65ml ± 1.0ml Vs. 2.02ml ± 1.65 ml), emulsification 41.5ml ± 15.2 Vs. 34 ml ± 14.3 ml) , cortical aspiration: 22.6 ml ± 13.8 ml Vs. 21.7 ± 13.9ml  and aspiration of viscoelastic: to 21.4 ml ± 9.4 ml Vs. 32.7 ml ± 10.7 ml. Descemet’s folds mean value: 0.42 ± 0.74 Vs. 0.26 ± 0.58. Corneal edema 0.20 ± 0.46  Vs. 0.22 ± 0.47.

Operating with low pulse energy provided by infrared nanosecond-laser may offers a safe and effective alternative to phacoemulsification for the majority of candidate cataract patients.  This laser probe, which is adaptable to most existing phacoemulsification systems, offers low energy levels and essentially no thermal corneal damage at the incision site.