[Laser phacoemulsification with the Paradigm Photon Laser. Surgical technique and first results]

Early clinical results and personal experience with a new technique in cataract surgery using Paradigm Photon Laser (neodymium Yag Laser) are reported. After the introduction of phako ultrasound in cataract surgery, Eichenbaum et al. examined the use of a laser system to improve cataract surgery. A phase I clinical trial was started in the USA in 1996 and a phase II clinical trial is currently ongoing. The Laser technique was performed as follows. A clear corneal incision measuring 2.8 mm, capsulorrhexis, hydrodissection and hydrodelineation of the nucleus and the epinucleus were performed first. A chopping instrument was then introduced by a second port to facilitate the laser procedure. Finally, the incision was enlarged to introduce the foldable IOL in the bag without suture. Eight eyes of six patients with a soft cataract were operated by Nd:YAG Laser, and followed for 6 to 10 months. No particular difficulty was observed concerning the technical procedure in comparison with the phako ultrasonic procedure. Photon laser may be an alternative treatment for softer cataracts with the following advantages: the vulnerability of the posterior capsule to the sharp needle of the phako ultrasonic instrument is eliminated using Photon Laser. There is no propensity for incisional burns nor ultrasonic vibration. However, additional progress is required for its application in hard cataract cases.