Clinical outcomes of femtosecond laser–assisted cataract surgery versus conventional phacoemulsification: A retrospective study in a tertiary eye care center in South India

Purpose: To compare the clinical outcomes of femtosecond laser–assisted cataract surgery (FLACS) versus conventional phacoemulsification (CP) in terms of refractive outcomes, cumulative dissipated energy, and intraoperative complications. Methods: In this retrospective study performed in a tertiary care ophthalmic hospital, we reviewed 2124 eyes that underwent FLACS or CP. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), cumulative dissipated energy (CDE), and intraoperative complications were analyzed in the study. Results: Out of 2124 eyes, 873 underwent FLACS and 1251 underwent CP. The postoperative mean UCVA after one month was 0.05 ± 0.11 logMAR and 0.14 ± 0.23 logMAR for FLACS and CP, respectively (P < 0.00001). Mean CDVA one month post operation was 0.02 ± 0.07 logMAR and 0.06 ± 0.19 logMAR for FLACS and CP, respectively (P < 0.0001). The CDE for the FLACS group was 6.17 ± 3.86 (P < 0.00001) and it was 9.74 ± 6.02 for the CP group. The intraoperative complication for the FLACS group was 1.60% and the CP group was 2.39% (P < 0.00001). Conclusion: The visual outcomes were better in FLACS compared to CP. The CDE was lower for the FLACS group and FLACS had significantly less intraoperative complications

Comparison between Active and Gravity-based Phacoemulsification Fluidics Systems in Immediate Sequential Bilateral Cataract Surgery

PURPOSE: To compare the clinical outcomes during phacoemulsification when using active fluidics (Centurion®) and gravity-based fluidics (Infiniti®) in immediate sequential bilateral cataract surgery. METHODS: From January 2015 to September 2015, 68 eyes of 34 patients with bilateral cataract were assigned to receive immediate sequential bilateral cataract surgery by Centurion® in one eye and Infiniti® in the other eye. We measured and compared intraoperative factors, including cumulative dissipated energy (CDE), ultrasound time, mean amount of balanced salt solution (BSS) used, and pain using a scale. Best corrected visual acuity (BCVA), central corneal thickness (CCT), and endothelial cell density (ECD) were also evaluated preoperatively and 1 month postoperatively. RESULTS: Intraoperative measurements showed significantly less CDE (5.05 ± 2.18 vs. 7.05 ± 3.82), ultrasound time (24.65 ± 9.68 vs. 34.95 ± 17.95 seconds), and mean amount of BSS used (37.06 ± 10.25 vs. 44.88 ± 16.38 mL) in the Centurion® group than in the Infiniti® group (p = 0.011, p = 0.005, p = 0.021, respectively). The intraoperative pain scale was 0.26 ± 0.51 in the Centurion® group and 0.50 ± 0.71 in the Infiniti® group, and was not significantly different (p = 0.121). BCVA, increase of CCT and decrease of ECD were not significantly different between the two groups at 1 month postoperatively. CONCLUSIONS: The efficacy of phacoemulsification in the Centurion® group was superior to that in the Infiniti® group. The level of intraoperative pain and clinical outcomes 1 month after surgery were not significantly different between the two groups.

The incidence of cystoid macular edema in patients with or without diabetes after uncomplicated phacoemulsification:A four-year study / 国际眼科杂志(Guoji Yanke Zazhi)

Abstract?AIM:To report the incidence of post-operative c ystoid macular edema ( pCME ) in patients with or without diabetes and its correlation with c umulative dissipated energy ( CDE ) and phaco -time after uncomplicated phacoemulsification.?METHODS:In the study 116 nondiabetic ( Group A) and 101 d iabetic patients ( Grou p B) underwent phacoemulsification.Preoperatively none of the groups ( A+B ) had signs of maculo pathy or diabetic macular edema documented by spectral-domain optical coherence tomography ( SD -OCT ) and fundus fluore scein angiography ( FFA ) . Phaco metrics were documented after surgery.FFA was performed two months after each operation . Patients with indications of pCME were reassessed with SD-OCT.?RESULTS: The incidence o fpCME after uncomplicated pha coemulsification was statistically significant difference between the two groups (15.8% in Group B versus 6.9%in Group A, P =0.03 <0.05).The subclinical pCME appeared in 19 out of 24 patients.There was a significant correlatio n between parametric values ( CDE, phaco -time, hardness of the lens ) and pCME occurrence. Glycosylated Hemoglobin ( HbA1c ) blood level s was statistically significant difference ( P =0.005 <0.05 ) between the patients who developed or not pCME. Cystoid mac ular edema did not correlate with the axial length of the eye.? CONCLUSION: There was statis itcally significant differen ce in the incidence of pCME after uneventful phacoemulsification between nondiabetic subjects and diabetics. Most of these patients with pCME had subclinical appearance.CDE and phaco-time data were important factors and predictors to pCME.Good glycemic controls prevent the incidence of pCME.

Comparison of Clinical Outcomes Between Torsional Phacoemulsification of Infiniti(R) and Longitudinal Phacoemulification of Stellaris(R) Through 2.2 mm Microincision

PURPOSE: To compare clinical outcomes of a 2.2 mm microcoaxial cataract surgery, using torsional mode and longitudinal mode. METHODS: In this comparative study, patients with bilateral cataract were assigned to get microcoaxial cataract surgery by torsional mode of infiniti in one eye and longitudinal mode of Stellaris(R) in the other eye. Primary outcome measures were US time (UST), cumulative dissipated energy (CDE), mean amount of balanced salt solution (BSS) used and surgical complications. Patients were seen 1, 7, 30, and 60 days after surgery. Postoperative outcome measures were the final best corrected visual acuity (BCVA), central corneal thickness (CCT), endothelial cell count and surgically induced astigmatism (SIA). RESULTS: The study evaluated 68 eyes of 34 patients (nuclear opalescence (NO)2: 40 eyes, and NO3: 28 eyes). CDE was significantly lower in torsional mode (3.52 +/- 2.93) than in longitudinal mode (6.20 +/- 3.32) (p = 0.001). Torsional mode (60.88 +/- 21.18 ml) had more BSS use than longitudinal mode (34.58 +/- 13.54 ml) (p 0.05). CONCLUSIONS: The torsional mode may provide lower level of phacoemulsification energy than the longitudinal mode and Torsional mode is considered effective and safe phacoemulsification. However the surgical outcomes were not significantly different in 2.2 mm microcoaxial cataract surgery of moderate cataract. So surgeon can choose any phaco machine based on experience and preference.

One-Year Outcome of Microcoaxial Cataract Surgery Using 1.8 mm and 2.2 mm Incisions Versus that of Conventional Cataract Surgery

PURPOSE: To compare the 1-year outcome of 1.8 mm and 2.2 mm microcoaxial cataract surgery (MCCS) versus 2.75 mm conventional cataract surgery (CCS). METHODS: The present study evaluated 120 eyes (40 eyes in each group). The mean ultrasound power, ultrasound time (UST), and cumulative dissipated energy (CDE) were measured preoperatively and at 1 day, 1, 2, 6 months, and 1 year postoperative. Visual acuity, number of corneal endothelial cells, and surgically induced astigmatism (SIA) were compared. RESULTS: In LOCS III NO4, 1.8 mm MCCS showed a statistically higher ultrasound time (p-value = 0.031) and CDE (p-value = 0.029), and the day 1 corneal thickness increase was relatively higher in 1.8 mm MCCS (p-value = 0.043) than other two groups. There were no differences in postoperative 1 year visual acuity or number of corneal endothelial cells among the groups. SIA was significantly lower in 1.8 mm and 2.2 mm MCCS compared to that of the conventional treatment (p-value = 0.046). CONCLUSIONS: There were no differences in postoperative 1 year mean endothelial cell density or corrected visual acuity between 1.8 and 2.2 mm MCCS and CCS at all cataract densities. The 1.8 mm and 2.2 mm MCCS techniques were as safe and effective as CCS, and SIA in 1.8 mm and 2.2 mm MCCS was significantly lower than that of CCS.