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AquaLase kinder on corneal endothelium in softer cataracts

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LONDON — Cataract surgery performed using AquaLase causes less endothelial cell loss than standard ultrasound phacoemulsification, according to a surgeon speaking here.

Edward Hughes, FRCOphth, and colleagues at Queen Mary's Hospital in Kent, England, conducted a prospective, randomized, controlled trial comparing rates of corneal endothelial cell loss between the two surgical modalities. The study included 81 patients with up to grade 3 cataracts; 43 patients received standard phacoemulsification and 38 received AquaLase. Both procedures were performed using the Alcon Infiniti Vision System, which incorporates the AquaLase modality.

Mr. Hughes presented 6-month data from the study here at the European Society of Cataract and Refractive Surgeons meeting.

At 2 to 3 weeks follow-up, AquaLase resulted in less mean endothelial cell loss than ultrasound in all cataract grades, he said; however, the difference did not reach statistical significance.

By 6 months, AquaLase resulted in a significantly lower endothelial cell loss rate for eyes with grade 1 cataracts preoperatively, although researchers again noted no significant difference from standard phaco for eyes with grade 2 or 3 cataracts, Mr. Hughes said.

"We should be cautious in interpreting this until this can be confirmed with a bigger study," he said. "There may be less of a detrimental effect on the endothelium with softer cataracts when using AquaLase when compared to phaco."