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L. Park, A.I. Miller, I. Ali, J. Dodick; Laser Photolysis Cataract Extraction, Irrigation Fluid and Corneal Edema . Invest. Ophthalmol. Vis. Sci. 2003;44(13):228.
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Purpose: To study factors in laser photolysis cataract extraction and their influence on post-operative corneal edema. Methods: Data was collected from patients who underwent cataract extraction by a single surgeon from August 20, 2002 to September 24, 2002, using both laser photolysis and phacoemulsification. Data included numer of laser shots and volume of irrigation fluid. Post-operative day one, corneal edema was graded by a single observer on a scale of 0 to 4. Statistical analysis was performed using the student t-test. Results: The total number of patients who underwent cataract extraction was 51. 30 (59%) underwent photolysis, while 16 (31%) underwent phacoemulsification. 4 (8%) patients had both photolysis and phacoemulsification, and 1 (2%) was converted to an extracapsular cataract extraction. The average patient age was 76 for photolysis and 80 for phacoemulsification. The average number of photolysis laser shots was 85 (stdv 37), and there was no correlation between the number of laser shots and corneal edema. The average irrigation volume during photolysis was 171 ml, not statistically different from phacoemulsification 187 ml (p>0.49). 75% of photolysis and 55% of phacoemulsification patients had low-grade corneal edema of (0-1). Fluid volume (155 ml) of photolysis/low-grade edema was statistically the same as phacoemulsification/low-grade edema (134 ml). Fluid volume (222 ml) in photolysis/high-grade edema (grade 2-4) also was not statistically different from fluid volume (238 ml) in phacoemulsification/high-grade edema. Although it appeared that patients with greater irrigation volumes had more corneal edema, the difference did not reach statistical significance (p=0.07). Conclusions: 1) The number of photolysis laser shots is not correlated with degree of corneal edema. 2) Irrigation fluid volume appears to be correlated with post-operative edema, although the data did not reach statistical significance. 3) There was no statistical difference in fluid volumes between photolysis and phacoemulsification. 4) A greater percentage of photolysis patients than phacoemulsification patients had low-grade corneal edema, although this was not statistically significant in this small study.
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