Preliminary evaluation of the clinical efficacy of femtosecond laser-assisted phacoemulsification

Objective To preliminarily evaluate the clinical efficacy of femtosecond laserassisted phacoemulsification. Methods In this prapective study, 167 patients (200 eyes) with cataract were randomly divided into two groups. There were 86 patients (100 eyes) in the femtosecond laser-assisted phacoemulsification group (femto group) and 81 patients (100 eyes) in the traditional phacoemulsification group traditional group. Phacoemulsification power and time were recorded for each procedure. Changes in surgically induced astigmatism (SIA), visual acuity, and corneal endothelial cell count were measured and complications were noted. Tear break-up time, the height of the tear meniscus and the grade of dry eye were also assessed preoperative and postoperative 1 week, 2 weeks, 1 month, 2 months for the two groups. Data were analyzed using independent t test and repeated measured ANOVA. Results Statistically significant differences were found in the effective phacoemulsification time (EPT) and the average phacoemulsification power (AVE) of the two groups (t=7.19 and 3.73, bothP 0.05) while the difference in the SIA was obvious (t=2.78,P<0.05). The corneal endothelial cell loss rate of the femtosecond group was lower than that of the traditional group when the nuclear lens was less than or equal to grade Ⅲ (t=2.31,P<0.05), while the loss rate was higher when the nuclear lens was above grade Ⅲ (t=3.92,P<0.05). In the femtosecond group, at 1 week postoperatively, there was a reduction in the mean tear break-up time and a large increase in the grade of dry eye (F=6.80,P<0.05). In the traditional group, at 1 week (P<0.05) and 2 weeks (P<0.05) postoperatively, there was a reduction in the mean tear break-up time and a large increase in the grade of dry eye (F=24.00,P<0.05). At 1 week, there was a significant increase in the mean height of the tear meniscus (F=6.48,P<0.05). Conclusion Femtosecond laser-assisted phacoemulsification is safe and efficient. It can reduce the use of ultrasonic energy, reducing SIA. The influence on the corneal endothelial cells differed according to the nuclear lens grade. The reason for this needs further study. Key words: Femtosecond laser; Phacoemulsification; Surgically induced astigmatism; Corneal endothelial cell; Xerophthalmia