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I.P. Glavas, A.I. Miller, D. Pettinelli, E. Shrier, J.J. Stein, I. Ali; Dodick Laser Photolysis Cataract Extraction Experience of Ophthalmology Residents at Manhattan Eye Ear and Throat Hospital . Invest. Ophthalmol. Vis. Sci. 2003;44(13):191.
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© ARVO (1962-2015); The Authors (2016-present)
Background: Cataract extraction using the Dodick laser photolysis system was approved by the FDA in June of 2000. The surgery is done through two small (less than 1 mm) clear corneal incisions and requires bimanual dexterity and the use of specific approaches for capsulorrhexis and nuclear fragmentation (either bowl technique or pre chopping). For the inexperienced hands of an ophthalmology resident, small incision cataract surgery, as a more delicate procedure, represents a new learning experience. Purpose: To present the experience of the Manhattan Eye Ear and Throat Hospital (MEETH) ophthalmology residents with the Dodick laser photolysis system, to describe the surgical outcomes of cataract extraction using the laser photolysis system and review and compare the preoperative and postoperative characteristics of the surgical cases. Methods: Retrospective review of cataract extraction using the laser photolysis system performed by four ophthalmology residents. The cases of 9 eyes, 5 OD and 4 OS, with no previous eye pathology, of 6 consecutive patients (average age 54±13) were reviewed. The following parameters were collected : pre- and postoperative visual acuity and intraocular pressure (IOP), preoperative cataract density, degree of postoperative inflammation, postoperative corneal appearance, duration of surgery, laser applications (energy) used, and intra-operative and postoperative complications. Results: Average preoperative and postoperative (month 1) best corrected visual acuity was 20/ 74 (0.27) and 20/ 29.5 (0.68) respectively. Average cataract density was 1.56 on a +1 to +4 scale by slit-lamp biomicroscopy. Average preoperative and postoperative IOP was 13.56mmHg and 14.67mmHg respectively (p=0.44). Average number of laser shots used was 29.8±22.5, representing (12mJ per shot) 357.6± 270mJ of average intraocular energy released. Average procedure time was 33±12.6min. Intra-operative complications included posterior capsule rupture and the need for anterior vitrectomy in 2 eyes. In all reviewed cases the intraocular lens implant was positioned "in the bag" with the exception of two cases that was placed in the sulcus. There was no significant postoperative inflammation and no corneal complications. Conclusions: Cataract surgery using the Dodick photolysis system seems to be a safe and relatively easy to learn procedure even by inexperienced surgeons.
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