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Impressum
Ultrasound and Erbium Laser Phaco - monocentric comparison of phaco time and energy
Gamael A., Höh H.
Klinikum Neubrandenburg, Augenklinik
Background: One year ago, we presented data of comparison between
erbium laser phacoemulsification (ELP) and ultrasound phacoemulsification
(USP). The importance of these data was limited because USP and ELP were
performed by different surgeons. in the current study, all USP and ELP
were performed by the same surgeon.
Methods: One surgeon (HH) performed surgery of all patients (out-patient
surgery) by ELP (668 eyes of 559 patients; 236 male, 323 female, age 17
- 94 years, m = 66.5 years) and USP (233 eyes of 188 patients; 71 male,
117 female, age 37 - 92 years, m = 73.5 years). USP was done by ultrasonic
phaco machine HARMONY (DORC, Netherlands); phaco time was measured and
converted to energy. ELP was done by PHACOLASE (Asclepion-Meditec Co.,
Jena, Germany). Phaco time and energy were read from the machine's display.
Nucleus hardness was determined intraoperatively after the Neubrandenburg
gradation for nucleus hardnesses of grade 0 - 4. Surgical technique was
equal in both groups (clear corneal incision, phaco chop technique, implantation
of a flexible intraocular silicone lens etc.).
Results: The part of ELP in all operations was 93.4 % in nucleus
hardness 0, 92.9 % in nucleus hardness 1, 71.0 % in nucleus hardness 2,
44.4 % in nucleus hardness 3 and 14.6 % in nucleus hardness 4. Phaco times
in USP/ELP were as follows: nucleus hardness 0: 2.7 s/7.2 s, nucleus hardness
1: 31.6 s/60.0 s, nucleus hardness 2: 42.1 s/107.4 s, nucleus hardness
3: 67.0 s/219.7 s, nucleus hardness 4: 107.6 s/262.7 s. Energy in USP/ELP
was as follows: nucleus hardness 0: 26.7 J/0.9 J, nucleus hardness 1:
315.6 J/25.2 J, nucleus hardness 2: 420.7 J/55.5 J, nucleus hardness 3:
670.3 J/157.6 J, nucleus hardness 4: 1.075.7 J/331.6 J.
Conclusion: Dependent on nucleus hardness, ELP takes 5 s to 4 min
longer than USP. But energy transfer into the eye was only 1/3 to 1/20
compared to USP.