Cataract Grade and Pupil: Comparison Between Conventional Phacoemulsification and Low-Energy Femtosecond Laser Assisted Cataract Surgery

Abstract

Ramiro Salgado,1 Paulo Torres,2 António Marinho,3 Filomena J Ribeiro4 1Departamento de Oftalmologia do Hospital da Arrábida, Hospital de Santo António, Centro Hospitalar e Universitário do Porto, Vila Nova de Gaia, Portugal; 2Departamento de Oftalmologia do Hospital da Prelada, Universidade do Porto, Porto, Portugal; 3Departamento de Oftalmologia do Hospital da Luz Arrábida, Universidade do Porto, Porto, Portugal; 4Departamento de Oftalmologia do Hospital da Luz Lisboa, Universidade de Lisboa, Lisboa, PortugalCorrespondence: Ramiro Salgado, Departamento de Oftalmologia do Hospital da Arrábida, Hospital de Santo António, Centro Hospitalar e Universitário do Porto, Praceta Henrique Moreira 150, Vila Nova de Gaia, 4400-346, Portugal, Tel [phone], Fax [phone], Email [email protected]: This study presents a comparison of pupil changes according to cataract grade between low-energy femtosecond laser-assisted cataract surgery (FLACS) and conventional phacoemulsification (CP) in the same patient.Patients and Methods: Data from surgical records from patients submitted to cataract surgery with CP in one eye and FLACS in the other were retrospectively reviewed. The inclusion criterion was both eyes of the same patient having the same cataract grade in accordance with Lens Opacity Classification System (LOCS) III. Total pupil variation (TPV) was measured after recorded images, with intraindividual comparison between techniques, according to cataract grade (≤ 3 and > 3), age and cumulative dissipated energy (CDE).Results: The study included a total of 124 eyes of 62 patients (mean age 72.65 ± 7.64 years). Analysis showed a statistically significant difference in TPV between techniques in the grade ≤ 3 cataract group (0.08 ± 0.22 mm²; p=0.034), with less pupil narrowing with FLACS, but not in the grade > 3 group (0.01 ± 0.23 mm²; p=0.849). Regarding CDE, a significant difference (p 74 years) for both techniques (p< 0.001).Conclusion: There was a statistically significant difference between techniques (although of mild clinical relevance), with less reduction of pupil area with FLACS in softer cataracts (grade ≤ 3), as compared to CP. Higher levels of CDE are associated with more pupil narrowing in CP.Keywords: cataract grade, pupil, low energy FLACS, femtosecond laser, phacoemulsification

Keywords

• cataract grade
• pupil
• low energy flacs
• femtosecond laser
• phacoemulsification