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Present state of erbium laser phacoemulsificationH. Höh
Background: Together with the MEGATRON (Geuder Co., Heidelberg, Germany), the bi-directional foot switch, the slimline handpieces and the 100-Hz PHACOLASE (Aesculap-Meditec Co., Jena, Germany) a new generation of erbiumlaserphaco systems is available.
Material and Method: Until now, we performed surgery in more than 100 eyes. Surgical techniques were corneal and corneoscleral access, capsulorhexis, hydrodissection, hydrodelineation, phaco-chop technique and implantation of the IOL into the capsular bag.
Results: Compared to the 60-Hz laser, erbiumlaser phacoemulsification was significantly optimized by the PHACOLASE. The mean phaco time was 1.8 min. In most cases, single pulse energies of 5 -10 mJ were sufficient. The repetition rate can be chosen continuously from 10 to 100 Hz. The mean total energy was 34 years. Capsular ruptures and laser specific complications did not appear in nucleus hardnesses ranging from 0 to 3. Nuclei with hardnesses of 4 can also be emulsified by the laser, but it still takes too long. But meanwhile new developed anti-clogging handpieces also allow emulsification of nuclei with hardness of 3 in few minutes.
Conclusion: The endothelial protection, the lower energy transmission into the eye compared to ultrasonic emulsification, the good handling and the various fields of application of the erbium laser in ophthalmology (eyelid surgery, glaucoma surgery, vitrectomy, capsulorhexis) led to the use of PHACOLASE in Neubrandenburg in eyes with nucleus hardnesses up to 3 routinely.
Augenklinik im Klinikum Neubrandenburg, PF 40 01 35, 17022 Neubrandenburg, Germany