Sauder G.

Department of Ophthalmology and Eye Hospital, Faculty of Clinical Medicine Mannheim, University of Heidelberg.

Objective: Safety and efficiacy of cataract surgery with topical anesthesia performed by an experienced phako surgeon using the Laserphakosystem Phakolysis® during the learning period.
Material and methods: Prospective, randomised clinical trial. 40 patients for routine cataract surgery with grade 1 and 2 cataract formation were consecutively included an roandomised in a phako group (PG) and laserphako group (LPG). Density of the cataract formation was evaluated by the surgeon using a subjective 1-4 scale with 1 for mild and 4 for mature cataract.Topical anaesthesia was applied using Novesine® drops 4-6 times preoperatively. The following parameter were evaluated: Visual acuity, duration of surgery, IOP, subjective pain score of the patient using a subjective 10 point visual scale.
Results: Postoperative visual acuity was 0.4 ± 0.24 ranging from finger couting to 0.9 in the PG and 0,28 ± 0.1 ranging from fingercouting to 0.4. Duration of surgery was 9.2 ± 1.4 minutes and 21.3 ± 2.7 minutes respectively. The subjective pain score was significantly higher in the LPG ( 4.2 ± 0.6,ranging from 2.5 to 6 ) to the PG ( 1.8 ± 0.5, ranging from 0 to 3). IOP did not differ significantly in both groups.
Conclusion: It was possible in any case to perfom laser phako with topical anaesthesia in the learning curve for an experienced phako surgeon. Postoperative visual acuity, subjective pain score an duration of surgery were significantly better in the PG.

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