OBJECTIVE: To analyze the advantages of femtosecond laser-assisted cataract ultrasound emulsion surgery from the perspective of precision cataract refractive surgery by clinical comparison of femtosecond laser-assisted cataract ultrasound emulsion surgery with manual cataract ultrasound emulsion surgery.
METHODS: From February to July 2015, 25 cases of femtosecond laser-assisted cataract ultrasound emulsion surgery and 25 cases of manual cataract ultrasound emulsion surgery were performed with the LenSx femtosecond laser surgical treatment device for femtosecond laser and the CENTURION® cataract ultrasound emulsion surgery system for cataract. Age: 35-78 years old, average 67.6 years old, including 21 cases of 32 eyes in men and 13 cases of 18 eyes in women. We followed up the above patients’ operated eyes on the following indicators: among them, we compared the surgical operation precision (incision, tear capsule, IOL position, corneal astigmatism), surgical safety (ultrasound energy, capsule breakage, corneal edema, postoperative inflammatory reaction), surgical indications and postoperative complications (macular edema, conjunctival congestion, incision leakage).
Results: Compared with manual cataract ultrasound emulsification, the femtosecond laser has perfect capsular tearing; precise controlled corneal incision in a square 3-plane shape – tighter and less prone to leakage; tiny energy fragmentation, photolysis effect, laser fragmentation of the nucleus into pre-defined shapes, greatly reducing hyperemulsion shattering, and not overly dependent on operator experience and skill. The procedure is reproducible and provides a more standardized and precise surgical platform. Surgical complications: intraoperative: pupil narrowing due to negative pressure suction, separation incision, individual circumferential capsular tear, posterior capsular rupture, and conjunctival congestion in most patients after surgery. Possible macular edema occurred in 3 patients due to high negative pressure effect. In addition, patients with cataracts with corneal leukoplakia, significant senile rings, nystagmus, and pupil dilatation greater than 7 mm nuclear hardness greater than grade IV had limitations of the femtosecond laser.
CONCLUSION: Femtosecond laser-assisted ultrasonic emulsion cataract aspiration is standardized as well as maneuverable and reproducible, which helps to promote standardized surgical techniques for cataract and is a major advancement in cataract surgery technology. Femtosecond laser-assisted cataract surgery has a short learning curve and few postoperative complications, which are irreplaceable for the promotion of contemporary precision cataract refractive surgery. At the same time, femtosecond laser-assisted ultrasonic cataract aspiration has relatively narrow surgical indications, and currently does not form an integrated machine with ultrasound emulsion instruments, which requires extra time for preoperative articulation and intraoperative movement.
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