Optimization of energy parameters during surgery of high-density cataract

Cover Page
Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract


The goal is to develop a combined technique for preliminary YAG laser fragmentation and Femto laser exposure on a CATALYS device and to evaluate its role in reducing the time and energy parameters of a surgery of high-density cataract.

Material and methods. The study included 118 patients (118 eyes) with age-related cataracts of the 3rd and 4th degrees of lens nucleus density. In the main group, before phacoemulsification (PE) with a Femto laser support and IOL implantation, preliminary YAG laser phacofragmentation of the lens nucleus was performed. In the first control group, PE was performed with Femto laser support and IOL implantation. In the second control group – PE with IOL implantation.

Results. A 35% decrease in the energy of the Femto laser action at a 3rd degree of lens nucleus density was achieved, and 40% – at the 4th degree, in comparison with the PE with the Femto laser support without preliminary YAG laser phacofragmentation, a 38% decrease in the cumulative ultrasound energy at 3rd degree of the lens nucleus density, and 42% at 4th degree compared with isolated ultrasonic cataract phacoemulsification.

Conclusion. The proposed modification of the technique of combined YAG laser and Femto laser exposure allows achieving during cataract surgery a complete fragmentation of the lens nucleus of a high degree of density, helps minimizing the risk of complications and reaching quick postoperative rehabilitation of patients.


Full Text

Restricted Access

About the authors

Alexander V. Tereshchenko

Kaluga branch of the S. Fyodorov Eye Microsurgery Federal State Institution

Email: nauka@eye-kaluga.com

Russian Federation, Kaluga

MD, Honored Doctor of the Russian Federation, Director of the Kaluga Branch

Irina G. Trifanenkova

Kaluga branch of the S. Fyodorov Eye Microsurgery Federal State Institution

Author for correspondence.
Email: nauka2@eye-kaluga.com
ORCID iD: 0000-0001-9202-5181

Russian Federation, Kaluga

Candidate of Medical Sciences, Deputy Director for Scientific Work

Alexander M. Ivanov

Kaluga branch of the S. Fyodorov Eye Microsurgery Federal State Institution

Email: nauka@eye-kaluga.com

Russian Federation, Kaluga

Candidate of Medical Sciences, Deputy Director for Medical Work

Marina V. Okuneva

Kaluga branch of the S. Fyodorov Eye Microsurgery Federal State Institution

Email: nauka2@eye-kaluga.com

Russian Federation, Kaluga

Candidate of Medical Sciences, Head of the Department of Cataract Surgery

Natalya A. Orlova

Kaluga branch of the S. Fyodorov Eye Microsurgery Federal State Institution

Email: nauka2@eye-kaluga.com

Russian Federation, Kaluga

Ophthalmologist

References

  1. Chan E, Mahroo OA, Spalton DJ. Complications of cataract surgery. Clin Exp Optom. 2010;93(6):379-389. https://doi.org/10.1111/j.1444-0938.2010.00516.x.
  2. Daien V, Le Pape A, Heve D, et al. Incidence, risk factors, and impact of age on retinal detachment after cataract surgery in France: a national population study. Ophthalmology. 2015;122(11): 2179-2185. https://doi.org/10.1016/j.ophtha.2015.07.014.
  3. Blomquist PH, Morales ME, Tong L, Ahn C. Risk factors for vitreous complications in resident-performed phacoemulsification surgery. J Cataract Refract Surg. 2012;38(2):208-214. https://doi.org/10.1016/j.jcrs.2011.10.001.
  4. Терещенко А.В. Оптимизация энергетических параметров ультразвуковой и лазерной хирургии катаракты с помощью предварительного транскорнеального эндокапсулярного ИАГ-лазерного воздействия на ядра катарактальных хрусталиков // Вестник офтальмологии. – 2003. – T. 119. – № 5. – С. 22–24. [Tereshchenko AV. Optimization of energy parameters of ultrasound and laser cataract surgery with a preliminary transcorneal endocapsular yag-laser impact exerted on the cataract lens nuclei. Vestnik oftal’mologii. 2003;119(5):22-24. (In Russ.)]
  5. Hatch KM, Schultz T, Talamo JH, Dick HB. Femtosecond laser-assisted compared with standard cataract surgery for removal of advanced cataracts. J Cataract Refract Surg. 2015;41(9): 1833-1838. https://doi.org/10.1016/j.jcrs.2015.10.040.
  6. Анисимова С.Ю., Анисимов С.И., Новак И.В., и др. Результаты факоэмульсификации катаракты с фемтолазерным сопровождением // Современные технологии катарактальной и рефракционной хирургии: Сб. научных статей. – М., 2013. – С. 31–35. [Anisimova SYu, Anisimov SI, Novak IV, et al. The results of phacoemulsification of cataract with femtosecond laser accompaniment. In: Sovremennyye tekhnologii kataraktal’noy i refraktsionnoy khirurgii: Sb. nauchnykh statey. Moscow; 2013. P. 31-35. (In Russ.)]
  7. Окунева М.В., Терещенко А.В., Гречанинов В.Б., Сидорова Ю.А. Фемто- и YAG-лазерные техники факофрагментации в хирургии катаракты // Современные технологии в офтальмологии. – 2016. – № 5. – С. 67–69. [Okuneva MV, Tereshchenko AV, Grechaninov VB, Sidorova YuA. Femto- and YAG-laser techniques of phacofragmentation in cataract surgery. Sovremennye tekhnologii v oftal’mologii. 2016;(5):67-69. (In Russ.)]
  8. Терещенко А.В., Трифаненкова И.Г., Романенко С.Я., и др. Фемтолазерная хирургия катаракты при различной степени плотности ядра хрусталика // Современные технологии в офтальмологии. – 2016. – № 5. – С. 93–95. [Tereshchenko AV, Trifanenkova IG, Romanenko SYa, et al. Cataract femtolaser surgery for varying degrees of lens core density. Sovremennye tekhnologii v oftal’mologii. 2016;(5):93-95. (In Russ.)]
  9. Романенко С.Я., Терещенко А.В., Трифаненкова И.Г., и др. Энергетические параметры фемтолазерного сопровождения хирургии катаракты при различной степени плотности ядра хрусталика // Практическая медицина. – 2016. – № 6. – С. 145–148. [Romanenko SYa, Tereshchenko AV, Trifanenkova IG, et al. Energy parameters of femtosecond laser cataract surgery support at different degrees of the lens nucleus density. Prakticheskaya meditsina. 2016;(6):145-148. (In Russ.)]
  10. Гречанинов В.Б., Терещенко А.В., Белый Ю.А., Демьянченко С.К. Лазерная деструкция катарактальных хрусталиков высокой степени плотности // Современные технологии в офтальмологии. – 2016. – № 4. – С. 66–68. [Grechaninov VB, Tereshchenko AV, Belyi YuA, Dem’yanchenko SK. Laser destruction of high-density cataract lenses. Sovremennye tekhnologii v oftal’mologii. 2016;(4):66-68. (In Russ.)]
  11. Abell RG, Kerr NM, Vote BJ. Femtosecond laser-assisted cataract surgery compared with conventional cataract surgery. Clin Exp Ophthalmol. 2013;41(5):455-462. https://doi.org/10.1111/ceo.12025.
  12. Abell RG, Kerr NM, Vote BJ. Toward Zero Effective Phacoemulsification Time Using Femtosecond Laser Pretreatment. Ophthalmology. 2013;120(5):942-948. https://doi.org/10.1016/j.ophtha.2012.11.045.
  13. Conrad-Hengerer I, Hengerer FH, Schultz T, Dick HB. Effect of fs laser fragmentation on EPT in cataract surgery. J Refract Surg. 2012;28(12):879-884. https://doi.org/10.3928/1081597X-20121116-02.
  14. Conrad-Hengerer I, Hengerer FH, Schultz T, Dick HB. Effect of fs laser fragmentation of the nucleus with different softening grid sizes on effective phaco time in cataract surgery. J Refract Surg. 2012;38(11):1888-1894. https://doi.org/10.1016/j.jcrs.2012.07.023.

Supplementary files

Supplementary Files Action
1.
Fig. 1. Fragmentation of the lens into 6 equal fragments with an additional grid to soften the lens

Download (403KB) Indexing metadata
2.
Fig. 2. Preliminary YAG laser fragmentation: a – of a cataractous lens nucleus of the 3rd degree of density; b – of a cataractous lens nucleus of the 4th degree of density

Download (474KB) Indexing metadata
3.
Fig. 3. Optical coherence tomography of the anterior segment of the eye

Download (211KB) Indexing metadata
4.
Fig. 4. Uniform distribution of cavitation bubbles. Complete fragmentation without excessive pneumodissection

Download (283KB) Indexing metadata

Statistics

Views

Abstract - 96

PDF (Russian) - 12

Cited-By


Article Metrics

Metrics Loading ...

PlumX

Dimensions


Copyright (c) 2020 Tereshchenko A.V., Trifanenkova I.G., Ivanov A.M., Okuneva M.V., Orlova N.A.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies