Comparison of phacoemulsification parameters between manual and femtosecond laser-assisted cataract surgery

Nilufer Yesilirmak, Vasilios F. Diakonis, Juan F. Batlle, Ibrahim O. Sayed-Ahmed, Zachary Davis, Daniel P. Waren, Sonia H Yoo, Terrence O'Brien, Kendall Donaldson

Research output: Contribution to journalArticle

Abstract

Objective: To compare the nucleus removal time (NRT) and cumulative dissipated energy (CDE) outcomes of traditional phacoemulsification and femtosecond laser-assisted cataract surgery (FLACS) performed by cornea attendings and fellows. Design: Prospective nonrandomized comparative study. Participants: A total of 410 eyes of 410 patients. Methods: Nucleus removal time and CDE were recorded from patients who underwent cataract surgery using either FLACS (Catalys, LenSx, or Victus) or traditional phacoemulsification technique performed by 3 cornea attendings and 4 cornea fellows. One-way analysis of variance with Bonferroni post hoc tests and unpaired t tests were used to determine the differences between groups. Results: There was no statistically significant difference in cataract grade between groups. NRT was significantly lower only when using the Catalys system compared with the LenSx and Victus platforms and the traditional surgery, in both the attending group (p = 0.006, p = 0.002, p < 0.000, respectively) and the fellow group (p = 0.049, p = 0.038, p = 0.011, respectively). With respect to CDE, there was no significant difference when using the laser systems compared with the traditional surgery in both attending and fellow groups (p > 0.05). NRT and CDE were significantly higher in the fellow group (NRT = 269.10 ± 117.67, CDE = 7.30 ± 4.83) compared with the attending group (NRT = 218.87 ± 109.67, CDE = 5.76 ± 3.66) in traditional cases; however, in FLACS cases, there was no significant difference in NRT and CDE between the fellow group and the attending group. Conclusions: Inexperienced surgeons seem to require more time and use more ultrasound energy during traditional phacoemulsification when compared with experienced surgeons. The use of FLACS seems to significantly improve the NRT of experienced and inexperienced surgeons.

Original languageEnglish (US)
JournalCanadian Journal of Ophthalmology
DOIs
StateAccepted/In press - Jan 1 2018

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Phacoemulsification
Cataract
Lasers
Cornea
Analysis of Variance

ASJC Scopus subject areas

  • Ophthalmology

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Comparison of phacoemulsification parameters between manual and femtosecond laser-assisted cataract surgery. / Yesilirmak, Nilufer; Diakonis, Vasilios F.; Batlle, Juan F.; Sayed-Ahmed, Ibrahim O.; Davis, Zachary; Waren, Daniel P.; Yoo, Sonia H; O'Brien, Terrence; Donaldson, Kendall.

In: Canadian Journal of Ophthalmology, 01.01.2018.

Research output: Contribution to journalArticle

Yesilirmak, Nilufer ; Diakonis, Vasilios F. ; Batlle, Juan F. ; Sayed-Ahmed, Ibrahim O. ; Davis, Zachary ; Waren, Daniel P. ; Yoo, Sonia H ; O'Brien, Terrence ; Donaldson, Kendall. / Comparison of phacoemulsification parameters between manual and femtosecond laser-assisted cataract surgery. In: Canadian Journal of Ophthalmology. 2018.
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abstract = "Objective: To compare the nucleus removal time (NRT) and cumulative dissipated energy (CDE) outcomes of traditional phacoemulsification and femtosecond laser-assisted cataract surgery (FLACS) performed by cornea attendings and fellows. Design: Prospective nonrandomized comparative study. Participants: A total of 410 eyes of 410 patients. Methods: Nucleus removal time and CDE were recorded from patients who underwent cataract surgery using either FLACS (Catalys, LenSx, or Victus) or traditional phacoemulsification technique performed by 3 cornea attendings and 4 cornea fellows. One-way analysis of variance with Bonferroni post hoc tests and unpaired t tests were used to determine the differences between groups. Results: There was no statistically significant difference in cataract grade between groups. NRT was significantly lower only when using the Catalys system compared with the LenSx and Victus platforms and the traditional surgery, in both the attending group (p = 0.006, p = 0.002, p < 0.000, respectively) and the fellow group (p = 0.049, p = 0.038, p = 0.011, respectively). With respect to CDE, there was no significant difference when using the laser systems compared with the traditional surgery in both attending and fellow groups (p > 0.05). NRT and CDE were significantly higher in the fellow group (NRT = 269.10 ± 117.67, CDE = 7.30 ± 4.83) compared with the attending group (NRT = 218.87 ± 109.67, CDE = 5.76 ± 3.66) in traditional cases; however, in FLACS cases, there was no significant difference in NRT and CDE between the fellow group and the attending group. Conclusions: Inexperienced surgeons seem to require more time and use more ultrasound energy during traditional phacoemulsification when compared with experienced surgeons. The use of FLACS seems to significantly improve the NRT of experienced and inexperienced surgeons.",
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AU - Yesilirmak, Nilufer

AU - Diakonis, Vasilios F.

AU - Batlle, Juan F.

AU - Sayed-Ahmed, Ibrahim O.

AU - Davis, Zachary

AU - Waren, Daniel P.

AU - Yoo, Sonia H

AU - O'Brien, Terrence

AU - Donaldson, Kendall

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