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Adam Prickett, Maria Cortina, Joshua Hou, Jose De la Cruz; Initial Resident Experience Performing Cataract Surgery with and without Femtosecond Laser. Invest. Ophthalmol. Vis. Sci. 2013;54(15):1838. doi: https://doi.org/.
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To document and compare the resident experience performing cataract surgery with femtosecond laser with standard cataract surgery performed without femtosecond laser.
17 eyes undergoing cataract surgery with use of the LenSx Femtosecond Laser and 27 eyes undergoing cataract surgery with standard phacoemulsification techniques without use of the laser from June 2012 to December 2012 were included in the study. All cases were performed by residents and fellows with attending supervision at the University of Illinois at Chicago. The LenSx was used to create corneal incisions in 16 of 17 LenSx cases, and anterior capsulotomy and lens fragmentation in all 17 LenSx cases. In the standard phacoemulsification group, these steps were performed manually and with standard phacoemulsification. The remaining steps of cataract surgery were performed in the same fashion in each group. Data were collected regarding the Cumulative Dissipated Energy (CDE), operative time, aspiration time, ease of nuclear removal (on a scale of 1-5, with 1 representing ease and 5 difficulty), ease of wound closure (1-5), degree of subconjunctival hemorrhage (1-5), and complications.
In the LenSx group, the CDE was 10.13 +/- 8.20 J compared with 13.88 +/- 12.27 J in the standard group. The operative time was 29.83 +/- 8.76 min. vs. 32.41 +/- 21.32 min., however the LenSx group also underwent laser application averaging 6.25 +/- 6.73 min. Aspiration time was 6.43 +/- 1.61 min. vs. 6.33 +/- 1.92 min. respectively. Nuclear removal was graded as 1.6 +/- 0.84 vs. 1.89 +/- 1.17, ease of wound closure was 1.64 +/- 0.92 vs. 2.22 +/- 1.48, and degree of subconjunctival hemorrhage was 1.8 +/- 1.36 vs. 1.1 +/- 1.8. In the LenSx group there were no complications, while the standard group had two posterior capsule tears. P values were all >0.05.
In this preliminary study of the incorporation of the LenSx femtosecond laser in early resident cataract training, there were similar amounts of CDE, operative duration, aspiration time, ease of nuclear removal and wound closure, subconjunctival hemorrhage, and complication rates, with trends toward less CDE, easier wound closure, greater subconjunctival hemorrhage, and fewer complications. This preliminary study shows that incorporating the LenSx system in early resident training can be done safely and effectively. Additional analysis using a larger pool of data is needed.
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