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R. W. Frey, K. Edwards, R. Naranjo Tackman, J. Villar Kuri, N. Quezada, T. Bunch, S. Bott; Changes in CDE With Laser Lens Fragmentation Compared With Standard Phacoemulsification Cataract Surgery. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5418.
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To determine if laser lens fragmentation reduces the need for phacoemulsification energy (as measured by CDE) in cataract extraction when compared to conventional phacoemulsification surgery.
Patients electing to undergo routine cataract surgery were recruited onto this study after explanation of the study aims and signing the Ethics Committee approved informed consent. The eye with the most visual compromise was operated on first using the laser procedure. Laser capsulotomy and lens fragmentation was followed by cataract surgery using the minimum phaco energy required to aspirate the lens. The fellow eye was subsequently operated on using standard phacoemulsification surgery. The amount of energy utilized in each surgery was recorded using the displayed Cumulative Dispersed Energy (CDE) in the Alcon Infiniti phacoemulsification device. The results were compared between the laser and conventionally treated groups.
A total of 38 laser treated eyes and 18 conventionally treated eyes were included in the analysis. For LOCSIII Grade 1 cataract, mean CDE was reduced by 26.4% while for Grade 2 the reduction was 59.1%. The biggest reduction in the maximum energy required to remove the lens was 66.4% for Grade 2 cataract (14.22 Laser vs 42.35 Phaco only) and the biggest reduction in the minimum energy required to remove the lens was 61.6% (0.94 laser vs 2.45 phaco only) for Grade 3 cataract.
Early data from clinical trials suggest that laser lens fragmentation can reduce the amount of ultrasound energy required to remove the cataractous lens. A larger sample of higher grade cataracts is required to determine the optimum cutting algorithms, to refine surgical technique used in conjunction with the laser fragmentation.
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