Effect of femtosecond laser fragmentation of the nucleus with different softening grid sizes on effective phaco time in cataract surgery.

PURPOSE To compare the effect of different fragmentation softening grids in femtosecond laser-assisted cataract surgery on effective phacoemulsification time (EPT). SETTING Ruhr University Eye Clinic, Bochum, Germany. DESIGN Prospective randomized clinical trial. METHODS The study evaluated the feasibility of using a femtosecond laser (Catalys Precision Laser System) to perform capsulotomy and lens fragmentation in the treatment of patients with senile cataract. Patients were evaluated preoperatively with the Lens Opacities Classification System III (LOCS III). Patients had laser refractive cataract surgery with 350 μm fragmentation grids or with 500 μm fragmentation grids. Both groups had phacoemulsification using pulsed ultrasound energy, and the EPT was evaluated. RESULTS Eighty patients were treated with 350 μm fragmentation grids and 80 patients with 500 μm fragmentation grids. The mean preoperative LOCS III grade was 3.7 ± 0.8 (SD) in the 350 μm group and 3.5 ± 0.8 in the 500 μm group. The mean laser treatment time was 66.4 ± 14.4 seconds in the 350 μm group and 52.8 ± 11.9 seconds in the 500 μm grid group and the mean EPT, 0.03 ± 0.05 seconds and 0.21 ± 0.26 seconds, respectively. CONCLUSION The use of the femtosecond laser-assisted system in cataract surgery with 350 μm grid softening led to a statistically significant lower EPT than the 500 μm grid. FINANCIAL DISCLOSURE Dr. Dick is a member of the medical advisory board of Optimedica Corp. No other author has a financial or proprietary interest in any material or method mentioned.