Laser Cataract Surgery: Curse of the Small Pupil

Dick, H. Burkhard; Gerste, Ronald D.; Schultz, Tim

doi:10.3928/1081597x-20130920-01

Cited by 11 publications

(6 citation statements)

References 3 publications

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“… 19 , 27 Intraoperative miosis of the pupil observed in some studies following pretreatment with the FL has also been attributed to increased prostaglandin levels after laser treatment. 28 , 32 Constricted pupils may increase surgical manipulation during phacoemulsification. Correspondingly, some studies have found a trend of higher risk of PCME development following FLACS compared with manual phacoemulsification.…”

Section: Discussionmentioning

confidence: 99%

<p>Cystoid Macular Edema Following Cataract Surgery with Low-Energy Femtosecond Laser versus Conventional Phacoemulsification</p>

Nuffel¹,

Claeys²,

Claeys³

2020

OPTH

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To compare postoperative changes in central subfield macular thickness (CSMT) and prevalence of cystoid macular edema (CME) in patients undergoing cataract surgery with low-energy femtosecond laser versus standard phacoemulsification. Design: This was a retrospective comparative real-world study. Methods: Postoperative data of 252 eyes of 165 patients were collected: 138 eyes received low-energy femtosecond laser-assisted cataract surgery (FLACS) and 114 eyes underwent conventional phacoemulsification cataract surgery (CPCS). Postoperative changes in CSMT and prevalence of CME were compared between the two groups. Results: There was a significant increase in mean CSMT from preoperative to postoperative values at 2.5 months in both the FLACS and CPCS group (p<0.001). Mean change (preoperation to 2.5 months postoperation) in CSMT was 6.2±11.5 µm in the FLACS group and 7.3±26.6 µm in the CPCS group, which was statistically significant but clinically not relevant. Comparison of mean changes in CSMT (preoperation to 2.5 months postoperation) between the FLACS and CPCS groups revealed no significant differences. The rate of pseudophakic CME (PCME) development was lower in the FLACS group (1.4%) than the CPCS group (4.4%; p=0.247). When using PREMED criteria to define clinically significant PCME, only 0.7% patients in the FLACS group and 1.8% in the CPCS group showed development of clinically significant PCME (p=0.586). Conclusion: The mean change in CSMT and occurrence of postoperative CME was lower in the low-energy FLACS group than the standard-phacoemulsification group; however, the difference was not statistically significant.

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Section: Discussionmentioning

confidence: 99%

<p>Cystoid Macular Edema Following Cataract Surgery with Low-Energy Femtosecond Laser versus Conventional Phacoemulsification</p>

Nuffel¹,

Claeys²,

Claeys³

2020

OPTH

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“…The cause of this phenomenon is currently under evaluation. It seems from case reports that the more time that elapses between laser pretreatment and the beginning of intraocular surgery, the narrower these pupils become [16].…”

Section: Marfan Syndromementioning

confidence: 99%

Femtosecond cataract surgery overcoming clinical challenges

Dick¹,

Gerste²,

Schultz³

2013

Expert Review of Ophthalmology

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Cataract surgery has been undergoing revolutionary changes over the last 5 years, welcomed by a number of surgeons, reluctantly observed and sometimes critically commented upon by others. The femtosecond laser has introduced new standards in precision and reproducibility when it comes to corneal incisions and capsulotomies, it has changed the way we deal with the lens: originally conceived as a 'pretreatment', the laser is on the way to render the original treatment -phacoemulsification -obsolete. In a relatively short time, challenging clinical situations have been tackled successfully: small pupils, mature cataracts and even congenital cataracts. With growing experience, the use of ultrasound energy could be substantially reduced, in most cases even eliminated and thus the chance of ultrasoundrelated complications. We also have reason to envision performing cataract surgery without employing ophthalmic viscosurgical devices. These developments have the potential to make cataract surgery significantly safer.

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“…It is assumed that a circular and well-sized capsulorhexis leads to less capsular bag shrinkage, lower posterior capsule opacification, and a better predicable effective lens position (5-8). The current standard technique in adults is the manually demanding continuous curvilinear capsulorhexis (CCC) (9). A new generation of image-guided femtosecond lasers was introduced into ophthalmology in 2009 (10-12).…”

Section: Introductionmentioning

confidence: 99%