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AquaLase more traumatic in grade 4 vs. lower grade cataracts
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LONDON — AquaLase is a good option for eyes with cataracts of lower densities, but may result in more endothelial cell loss due to longer surgical time in eyes with more dense cataractous lenses, according to a surgeon speaking here.
Oleg Fechin, MD, of the IRTC Eye Microsurgery Ekaterinburg Center in Russia, studied the effects of using AquaLase on cataracts of varying densities in a series of 108 eyes. He presented the results at the European Society of Cataract and Refractive Surgeons annual meeting.
The AquaLase technique is an option included with the Infiniti phacoemulsification machine (Alcon).
Patients ranged in age from 16 to 74 years and were divided into four groups according to the cataract grade. The study included 66 eyes with senile cataract and 24 eyes with complicated cataract. Most cataracts were grade-2 and grade-3 densities, Dr. Fechin said.
The researchers found a proportional increase in mean procedural time with increasing cataract density, as follows:
- Grade-1 cataracts: 0.2 minutes;
- Grade-2 cataracts: 1.1 minutes;
- Grade-3 cataracts: 2.1 minutes; and
- Grade-4 cataracts: 3.6 minutes.
Similarly, the power required for procedures increased proportionately as cataract density increased, from 18% for grade-1 cataracts to 65% for grade-4 cataracts, Dr. Fechin said.
Endothelial cell loss did not significantly differ from grades 1 to 3. However, eyes with grade 4 cataracts had a significantly greater endothelial cell loss with AquaLase, averaging 14% compared to 11% for standard phaco.
"The traumatic effects of AquaLase on the eye are comparable to phaco," Dr. Fechin said. "AquaLase may not be justified in cases with grade-4 nucleus."