Nanosecond Laser Cataract Surgery in LOCS III Grade 4 and 5: A Case Series

Sauder, Gangolf; Ruf, Elena; Moedl, Sarah; Thyzel, Reinhardt

doi:10.22608/apo.2017123

Cited by 4 publications

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“…The two groups were well-matched in terms of preoperative parameters, including age, best-corrected visual acuity (BCVA), and nucleus density. Preoperative specular microscopy data [endothelial cell density (ECD), coefficient of variation (CoV), and hexagonality] were comparable between the two groups and fell within the normal range reported in the literature ( 17 , 18 ), except for a slightly lower hexagonality rate. The ECD in our cohort was thinner than reported in other studies, possibly due to anatomical variations among regions ( 19 ).…”

Section: Discussionsupporting

confidence: 61%

Qualitative and quantitative endothelium changes after cataract surgery: ultrasound phacoemulsification vs. nanolaser technique

Zbiba,

Kharrat,

Sayadi

et al. 2023

Front. Med.

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PurposeThe aim of this study was to evaluate corneal endothelial cell density and morphology, central corneal thickness, and best visual acuity using ultrasound (US) phacoemulsification or nanosecond laser technique.SettingDepartment of ophthalmology, Nabeul, Tunisia.DesignProspective cohort study.MethodsThis study included eyes with nuclear cataracts with a density grade of 1, 2, 3, or 4 according to LOCS III, divided into two groups; group 1 had conventional US, and group 2 had nanosecond laser. The endothelial cell density (ECD), coefficient of variation (CoV) in cell size, percentage of hexagonal cells, central corneal thickness (CCT) and best visual acuity (VA) were evaluated during 24 months.ResultsSeventy-four eyes had uneventful surgery, 40 in group 1, 34 in group 2. Three procedures in group 2 required conversion to standard phacoemulsification. The mean ECD decreased from 2616.4 ± 194.6 cells/mm2 in group 1 preoperatively to 2088.4 ± 229.9 after 2 years. In group 2, it decreased from 2611.8 ± 186.5 cells/mm2 to 2276.4 ± 163.8 after 2 years. The change was statistically significant in both groups. The decline of the mean ECD in group 2 was significantly less important than in group 1 (p = <10−2). The mean percentage of hexagonal cells was 45.18 ± 4.9 preoperatively and 43.5% ± 6.6 after 2 years in group 1. In group 2, it remained almost stable with 45.6 ± 5.1 and 45.4% ± 6.6 preoperatively and after 2 years, respectively. Preoperatively, the mean CoV was 0.39 ± 0.037 in group 1 and 0.38 ± 0.04 in group 2. After 2 years, it was 0.38 ± 0.04 and 0.37 ± 0.038 in group 1 and group 2, respectively. The changes of the mean CoV and the mean percentage of hexagonal cells were significant in both groups, but the difference between the groups was significant only during the six first months postoperatively. In preoperative, the mean corneal central thickness was 509.7 ± 19.5 in group 1 and 510.3 ± 20.4 in group 2. In both groups, the mean corneal thickness increased on D1 postoperatively to 550.9 in group 1, and 528.2 in group 2. The mean corneal thickness decreased more rapidly after 1 week in group 2, to find the initial values. Visual acuity improved from 0.76 Log Mar ± 0.5 at enrolment to 0.45 Log Mar ± 0.2, and 0.033 Log Mar ± 0.086 in group 1 at 1 day post-operative and after 24 months, respectively and from 0.58 Log Mar ± 0.28 to 0.2 Log Mar ± 0.09 and 0.035 Log Mar ± 0.083, respectively in group 2. There was no significant difference in VA at each follow-up between groups except for day 1.ConclusionOur study showed lower corneal tissue trauma, and lower endothelial cell loss in the laser cataract surgery compared to phacoemulsification.Clinical trial registration: (https://classic.clinicaltrials.gov/ct2/show/NCT05886283), identifier NCT05886283.

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Section: Discussionsupporting

confidence: 61%

Qualitative and quantitative endothelium changes after cataract surgery: ultrasound phacoemulsification vs. nanolaser technique

Zbiba,

Kharrat,

Sayadi

et al. 2023

Front. Med.

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“…Since the endothelial cell layer is a monolayer, compensation for lost cells involves the entire layer. The NanoLaser handpiece tip, the component that enters the corneal incision, is very similar to that used in phacoemulsi cation in terms of the damage that can be caused by mechanical movement of the tip within the eye [10]. The main difference is the total lack of energy loss within the tunnel with the transmission of laser energy through the ber optic, in stark contrast to the heat generated with phacoenergy.…”

Section: Discussionmentioning

confidence: 99%

“…[6] Several authors have reported endothelial cell sparing [7][8][9], including in harder cataracts. [10] The primary aim of this quality control [11] single-center two surgeon retrospective cross-sectional study was to compare endothelial cell loss following NanoLaser cataract surgery with and without the integration of the Soft-Shell technique. Secondary objectives were to evaluate the effect of laser energy and follow-up time on variations of the endothelial cell density, Coe cient of Variance, and central corneal thickness.…”

Section: Introductionmentioning

confidence: 99%

Nanosecond Laser Cataract Surgery with Soft-Shell technique: Effect on Endothelial Cell Loss

Blomberg,

Wübbolt,

Awe-Krüger

et al. 2023

Preprint

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Purpose The primary aim was to compare endothelial cell loss following NanoLaser cataract surgery with and without the integration of the Soft-Shell technique. Methods Digital records of eyes with LOCS III grade 2 or 3 cataracts that underwent uncomplicated surgery for removal without post-operative complications or secondary procedures at Hildesheim-Alfeld-Bockenem Eye Center (Hildesheim, Germany) were included in the quality control single-center two surgeon non-randomized retrospective cross-sectional study. Inclusion criteria included one baseline and at least one follow-up automated non-contact specular microscopy for endothelial cell density, rate of polymegethism represented by coefficient of variance, and pachymetry. Surgical procedures were performed by two surgeons using a standardized bimanual cataract extraction procedure without intraocular antibiotics, with one also integrating the Soft-Shell technique. Results Fifty-five eyes of 36 patients were enrolled. Comparison of laser energy required to complete surgery for the two groups did not yield statistically significant differences. Differences in the modification of endothelial cell density, coefficient of variance and central corneal thickness during the follow-up period between the two groups were not statistically significant. The number of cells lost due to surgery was calculated by using linear regression analysis, showing that NanoLaser + Soft-Shell procedure induced a cell loss of -46 ± 88 cells and the NanoLaser procedure 155 ± 87 cells (p = .002). Conclusions NanoLaser cataract surgery used less energy and did not require intraocular antibiotics (all single-use instruments) thus reducing endothelial cell loss. With the addition of the Soft-Shell technique this sparing was even greater.

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Que sera la chirurgie de la cataracte du futur ? Alternatives et voies de développement

Hassani

Sandali

Ouadfel

et al. 2020

Journal Français d'Ophtalmologie

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Nanosecond Laser Cataract Surgery in LOCS III Grade 4 and 5: A Case Series

Abstract: Harder cataracts should no longer be considered a limitation for the use of nanosecond laser in cataract surgery.

Cited by 4 publications

References 0 publications

Qualitative and quantitative endothelium changes after cataract surgery: ultrasound phacoemulsification vs. nanolaser technique

Qualitative and quantitative endothelium changes after cataract surgery: ultrasound phacoemulsification vs. nanolaser technique

Nanosecond Laser Cataract Surgery with Soft-Shell technique: Effect on Endothelial Cell Loss

Que sera la chirurgie de la cataracte du futur ? Alternatives et voies de développement

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