Femtosecond Laser-Assisted Facoemulsification of Hypermature Cataract

Aim. The development and clinical study of optimized femtosecond laser-assisted phacoemulsification (PE) technology of hypermature cataract.

Patients and methods. Femtosecond laser-assisted PE of hypermature cataract was performed in 72 patients (72 eyes). The 1st group included 45 patients (45 eyes) who underwent a femtolaser capsulorexis with a pulse power of 6,700 nanojoules (optimized technique for femtosecond laser-assisted РE). The 2nd group included 27 patients (27 eyes) who underwent a femtolaser capsulorexis with a pulse power of 7000 nanojoules.

Results. The use of a femtosecond laser to perform anterior capsulorexis in case of PE hypermature cataract is a technique that allows to obtain capsulorexis of an ideal round shape with high diameter accuracy, which is not possible with manual capsulorexis in patients with hypermature cataract. In the 2nd group, radial tear of the edge of capsulorhexis was noted in 2 (7.4 %) cases. In the postoperative period, in all cases in the 1st group, the periphery of the IOL optics was covered with a smooth edge of capsulorhexis of a regular round shape around the entire circumference. In the 2nd group, in 2 (7.4 %) cases, the exit of the edge of the IOL optics from under the edge of the capsulorexis was noted due to its radial tear with the shift of the IOL optics anteriorly, which can negatively affect the accuracy of the refractive result of IOL implantation. Visual acuity without correction and with maximum correction did not have significant differences in both groups and depended on the state of the neuroreceptor apparatus. The average loss of corneal endothelial cells in the 1st group was 5.7 ± 1.4 % and 8.7 ± 1.8 % in the 2nd group (p < 0.05).

Conclusion. The use of a femtosecond laser to perform anterior capsulorhexis in PE of hypermature cataract is an effective surgical technique for the treatment of hypermature cataracts, which ensures a fully in-the-bag  position of the IOL in the postoperative period. Optimization of the energy parameters of a femtosecond laser helps prevent capsulorexis edge tears in patients with hypermature cataract.

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