Effects of Femtosecond Laser-Assisted Cataract Pretreatment on Pupil Diameter: A Comparison Between Three Laser Platforms

Diakonis, Vasilios F.; Yeşilırmak, Nilüfer; Sayed-Ahmed, Ibrahim O.; Warren, Daniel; Kounis, George A.; Davis, Zachary; Cabot, Florence; Yoo, Sonia H.; O’Brien, Terrence P.; Donaldson, Kendall E.

doi:10.3928/1081597x-20151229-03

Cited by 25 publications

(28 citation statements)

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“…A recent comparative series investigating pupil diameter before and after laser cataract surgery reported that laser pretreatment induced significant pupillary miosis with the pupil diameter falling below 5 mm in 4.0% of cases. 25 In a series of 1500 laser cataract operations, the intraoperative pupil constriction rate was reduced from 9.5% in the first 200 cases to 1.2% for the latter 1300 cases when an additional one drop of 10% phenylephrine was given after the laser procedure. 12 The authors also noted that factors such as platform evolution, which shortened overall procedure time, and more efficient scanning patterns that reduced the required delivered energy, may also have been partly attributable.…”

Section: Discussionmentioning

confidence: 99%

Initial experience using a femtosecond laser cataract surgery system at a UK National Health Service cataract surgery day care centre

2016

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ObjectivesTo describe the initial outcomes following installation of a cataract surgery laser system.SettingNational Health Service cataract surgery day care unit in North London, UK.Participants158 eyes of 150 patients undergoing laser-assisted cataract surgery.InterventionsLaser cataract surgery using the AMO Catalys femtosecond laser platform.Primary and secondary outcome measuresPrimary outcome measure: intraoperative complications including anterior and posterior capsule tears. Secondary outcome measures: docking to the laser platform, successful treatment delivery, postoperative visual acuities.ResultsMean case age was 67.7±10.8 years (range 29–88 years). Docking was successful in 94% (148/158 cases), and in 4% (6/148 cases) of these, the laser delivery was aborted part way during delivery due to patient movement. A total of 32 surgeons, of grades from junior trainee to consultant, performed the surgeries. Median case number per surgeon was 3 (range from 1–20). The anterior capsulotomy was complete in 99.3% of cases, there were no anterior capsule tears (0%). There were 3 cases with posterior capsule rupture requiring anterior vitrectomy, and 1 with zonular dialysis requiring anterior vitrectomy (4/148 eyes, 2.7%). These 4 cases were performed by trainee surgeons, and were either their first laser cataract surgery (2 surgeons) or their first and second laser cataract surgeries (1 surgeon).ConclusionsDespite the learning curve, docking and laser delivery were successfully performed in almost all cases, and surgical complication rates and visual outcomes were similar to those expected based on national data. Complications were predominately confined to trainee surgeons, and with the exception of intraoperative pupil constriction appeared unrelated to the laser-performed steps.

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Section: Discussionmentioning

confidence: 99%

Initial experience using a femtosecond laser cataract surgery system at a UK National Health Service cataract surgery day care centre

2016

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“…[13] Researchers believe that increased levels of prostaglandin E2 (PGE2), as measured immediately after laser pretreatment, are responsible for intraoperative narrowing of the pupil. [12,13,14,15] PGE2 is released when ocular tissue is exposed to femtosecond laser cutting side effects. [16]…”

Section: Introductionmentioning

confidence: 99%

Changes in Pupil Area During Low-energy Femtosecond Laser Assisted Cataract Surgery

Mirshahi¹,

Ponto

2019

JOVR

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PurposeTo study the potential changes in pupil area within low-energy femtosecond-laser assisted cataract surgery (FLACS).MethodsA retrospective assessment of the pupil size was performed in the eyes undergoing FLACS using the Ziemer LDV Z8. We measured the pupil diameters as part of the images taken preoperatively and at the completion of laser pretreatment (after releasing the suction). We calculated the pupil area in 40 eyes of 40 patients (14 right and 26 left eyes). The mean ± standard deviation (SD) of age of the patients was 74 ± 7.4 years (range: 51-87). Paired t-test was used for statistical analyses. Subgroups were built with reference to age and preoperative pupil area (smaller than or equal to the median versus larger than the median).ResultsThe mean ± SD axial length, anterior chamber depth, white-to-white distance and lens thickness were 24.01 ± 1.47, 3.23 ± 0.4, 11.97 ± 0.49, and 4.59 ± 0.41 mm, respectively. The mean ± SD pupil area was 39.33 ± 7.1 mm2 preoperatively and 39.3 ± 6.75 mm2 after laser pretreatment. The mean ± SD change in pupil area was -0.03 ± 2.12 mm2. There were no statistically significant changes between preoperative and post-laser pupil areas (P = 0.93, 95% CI: -0.71 to 0.65). Comparisons within subgroups also did not detect pupil area reduction.Conclusion This study did not detect statistically significant changes in pupil area after laser pretreatment using low-energy FLACS. This observation is in contrast to previous studies using other laser platforms.

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“…Although we did not test other modules on the Z8, it can also be used for refractive surgery and keratoplasty which could be beneficial when sharing the device among other departments in a comprehensive ophthalmic teaching center. Moreover, studies have shown pupil miosis after femtosecond laser application during FLACS [ 24 , 25 ]. However, in our study, we did not use any preoperative non-steroidal anti-inflammatory eye drops and still did not find significant pupil miosis.…”

Section: Discussionmentioning

confidence: 99%

Femtosecond laser-assisted cataract surgery in a public teaching hospital setting

2018

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BackgroundTo evaluate the efficiency and practicality of femtosecond laser assisted cataract surgery (FLACS) in a public teaching hospital setting using a mobile FLACS system compared to conventional phacoemulsification cataract surgery (CPCS).MethodsNinety eyes from 90 patients underwent either FLACS or CPCS (45 in each group). Cataracts were graded using the Lens Opacities Classification System III system. Outcome measures included total surgery duration, femtosecond laser treatment time, vacuum time (VT), total phacoemulsification time (TPT) and total phacoemulsification power (TPP).ResultsNo differences were observed in the preoperative mean cataract grades and co-morbidities. FLACS took longer than CPCS with a mean difference of 5.2 ± 4.5 min (range: 0–18.8 min). The average femtosecond laser treatment time was 4.3 ± 3.4 min (range: 1–15.5 min). The VT was 2.51 ± 0.45 min (range: 1.59–4.10 min). Although not significant, TPT in FLACS showed a trend towards improvement (mean 1.0 ± 0.6 s; range: 0.1–2.4 s) compared to CPCS (mean 1.2 ± 0.6 min; range: 0.5–2.5 min). Whereas, TPP was significantly less in FLACS (mean 17.9 ± 5.0%; range: 5–27%) compared to CPCS (mean 20.3 ± 4.1%; range: 12.0–28.7%)(p = 0.031).ConclusionsThe mobile FLACS system housed in the same operating room increased the surgical duration by 5.2 min. The average VT was 2.51 min, which was lower in comparison to published experience using non-mobile FLACS systems.

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Effects of Femtosecond Laser-Assisted Cataract Pretreatment on Pupil Diameter: A Comparison Between Three Laser Platforms

Cited by 25 publications

References 14 publications

Initial experience using a femtosecond laser cataract surgery system at a UK National Health Service cataract surgery day care centre

Initial experience using a femtosecond laser cataract surgery system at a UK National Health Service cataract surgery day care centre

Changes in Pupil Area During Low-energy Femtosecond Laser Assisted Cataract Surgery

Femtosecond laser-assisted cataract surgery in a public teaching hospital setting

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