Cortex removal after laser cataract surgery and standard phacoemulsification: a critical analysis of 800 consecutive...

To evaluate the ease of anterior cortex removal and hydrodissection of the lens in femtosecond laser-assisted cataract surgery compared with standard phacoemulsification.

In the femtosecond laser-assisted cataract surgery group (400 eyes), a femtosecond laser was used for capsulotomy and followed by lens fragmentation. In the standard group, the capsulorhexis was performed manually. In both groups, a normal hydrodissection was set, the nucleus was aspirated with or without ultrasound phacoemulsification energy, and residual cortex removal and posterior capsule polishing were performed using bimanual irrigation/aspiration. The primary end point was the time (in seconds) required for the removal of the cortex from instrument insertion in the eye until aspiration tip removal. Secondary end points were the effective phacoemulsification time, quality of the anterior capsule, and anterior or posterior capsule ruptures.

Cortex removal time measured 30 ± 13 seconds (range: 10 to 76 seconds) for the standard group and 27 ± 10 seconds (range: 9 to 72 seconds) for the femtosecond laser-assisted cataract surgery group (P < .005). After laser-assisted capsulotomy, one capsule was still adherent following removal by forceps. No anterior or posterior capsular tears were observed in either group.

In femtosecond laser-assisted cataract surgery, the biaxial cortex removal time was comparable with the time in standard phacoemulsification.