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Clinical results using the Nd-YAG Lasersystem (Dodick photolysis) for cataract surgery 12-month follow up.H. B. Eckhardt, W. W. Huetz, A. W. Heinrich
Purpose: We report intraoperative and postoperative results of 100 consecutive cataract patients who underwent surgery between October 1998 and May 1999 using a new pulsed Q switch Nd-YAG Laser. Patients were allocated to 3 groups depending on the hardness of the nucleus using the LOCS III system as discribed by Chylack.Group I (NO £ 2,9) : 48 patients, group II (NO : 3,0 3,9 ) : 46 patients, group III (NO ³ 4,0): 6 patients.
Methods: Plasma was generated with a pulsed Q switch laser (ARC GmbH, Germany). A clear cornea incision of 1.25 mm gave access to the laser tip, the IOL was implanted via a separate 3.2mm clear cornea incision. Intraoperative laser pulse rate and total energy were recorded. Pre- and postoperative (2 days resp. 6 months p.o., 12 month p.o.) data of central cornea pachymetry were compared. The prodecure is demonstrated and possible complications are described.
Results: Mean total energy amounted to 1,97 J (± 1.43) in group I, 3,37 J (± 1,59) in group II and 7,70 J ( ± 2,09) in group III. No significant postoperative changes were seen compared to preoperative central pachymetry in groups I and II, whereas group III showed a 3% postoperativ increase (2 day). This might be a consequence of the higher volume of intraoperative BSS in this group. Six months and 12 month postoperatively no significant differences were found compared to preoperative values.
Discussion: A new technical procedure, photolysis of the lens nucleus, is now available for the experienced surgeon for cataract surgery. Today the technique can be used safely and efficiently for nuclei with a hardness of up to NO : 3,9 (LOCS III by Chylack). Compared to phacoemulsification technique the energy required for lens removal is reduced to 1/6.
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