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Paper Information

Journal:   JOURNAL OF CURRENT OPHTHALMOLOGY   2004 , Volume 16 , Number 4; Page(s) 1 To 8.
 
Paper: 

PHOTOLYSIS USING THE DODICK-ARC LASER SYSTEM FOR CATARACT SURGERY

 
 
Author(s):  HASHEMI H.*, KHANLARI M.
 
* TEHRAN UNIVERSITY OF MEDICAL SCIENCES, FARABI HOSPITAL
 
Abstract: 

Purpose: To evaluate the clinical effectiveness and safety of the Nd:YAG laser for cataract surgery and to compare clinical results and complications with ultrasound phacoemulsification.
Methods: In this prospective randomized clinical study, 30 eyes of 30 patients scheduled for cataract surgery were allocated based on hardness of the nucleus using the Lens Opacity Classification System III (LOCS III) system and assigned to 2 groups for lens emulsification: Nd:YAG laser or ultrasound. A complete ophthalmologic examination including slit-lamp biomicroscopy, refraction, fundoscopy, tonometry, endothelial cell count and pachymetry was performed preoperatively. A clear corneal approach for laser phaco surgery and a posterior limbal or scleral tunnel approach for ultrasound phaco were selected. All patients received a foldable posterior intraocular lens.
Results: There was no significant difference between mean of preoperative UCVA and BCVA in two groups. The mean of UCVA changed from 0.28±1:0.14 to 0.75±1:0.15 in Nd:YAG laser group and from 0.30±0.15 to 0.65±0.18 in ultrasound group 2 months after cataract surgery. Complete emulsification of the lens nucleus using the Nd:YAG was not achieved in 3 eyes of grade 3 nucleus sclerosis. Mean phacoemulsification time in Nd:YAG was 2.58 minutes ±14(SD) in group 1 and 4.7±1.8 in group 2 and significantly more than was done in ultrasound phaco (1.1±0.26 in group 1 and 1.5±0.43 in group 2).
Mean of total applied energy was 1.96±1.42 J and 3.5±1.71 J in 2 groups of Nd:YAG laser, and significantly less than ultrasound phaco 206.3±84.3 and 361.2±143.3 J respectively. There was no significant difference between endothelial cell counts. There were no vision-threatening complications.
Conclusion: Emulsification of the lens using Nd:YAG laser was effective for performing small incision cataract surgery in eyes with soft and medium nuclei.
Compared with US phaco, higher nuclear sclerosis grade take a relatively long time to emulsify and to achieve faster emulsification for higher grades, both the surgical technique and the surgical equipment must be optimized.

 
Keyword(s): CATARACT, PHACOEMULSIFICATION, LASER, ULTRASOUND, SMALL INCISION
 
References: 
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