Clinical analysis of femtosecond laser fragmentation of the nucleus with different sizes in cataract surgery

Objective To compare the effect of different fragmentation softening grids in femtosecond laser-assisted cataract surgery on cumulative dissipated energy (CDE), effective phacoemulsification time (EPT), balanced salt solution volume during surgery and corneal endothelial cell loss. Methods A prospective cohort study of all patients (66 cases, 75 eyes) who accepted femtosecond laser-assisted cataract surgery in Xiamen ophthalmic center during June 2015 to November 2015 were randomly divided into 3 groups: group A: Frag and Chop (350 mm fragmentation grids and octants); group B: Cylinder (diameter:3.0mm); group C: Chop (sestants). Patients were evaluated preoperatively with the Lens Opacities Classification System III (LOCS III). The CDE, EPT, balanced salt solution volume, corneal endothelial cell loss and best corrected visual acuity (BCVA) at one month were compared. Results There was no statistically significant difference in LOCS III, preoperative corneal endothelial cell count in three groups (P >0.05). Comparing with the group B and C, the CDE, EPT and postoperative corneal endothelial cell loss were significantly lower in group A (CDE: group A: 4.7±2.8, group B: 6.4±3.1, group C: 6.6±3.0; EPT: group A: 23.9±12.0s, group B: 30.8±11.7s, group C: 32.1±12.6s; corneal endothelial cell loss: group A: 4.2±4.3%, group B: 6.7±4.4%, group C: 7.2±4.8%; P 0.05). Conclusions The use of the femtosecond laser-assisted system in cataract surgery with frag and chop led to a statistically significant lower CDE, EPT and postoperative corneal endothelial cell loss. Key words: Femtosecond laser; Cataract; Fragmentation; CDE; EPT