Comparison of hybrid and cross fragmentation patterns in terms of phaco time and corneal effects

To compare two different fragmentation patterns in femtosecond laser-assisted cataract surgery (FLACS) in terms of phaco values, postoperative endothelial cell count (ECC) and corneal thickness (CT).

This non-randomized, retrospective cross-sectional study included patients with senile cataract of grade 3 who underwent FLACS using the LenSx laser system. In Group 1 (32 eyes), lens fragmentation was created as a cross pattern. In Group 2 (35 eyes), lens fragmentation was created as a hybrid pattern. Intraoperative measurements were of the femtosecond procedure time, the ultrasound (US) total time, effective phacoemulsification time (EPT) and mean phacoemulsification power (MPP). Postoperative measurements were of CT and ECC at day 1, day 7 and 4 weeks after surgery.

MPP and the US total time were significantly less with the hybrid pattern (P < 0.001, and P = 0.003). The EPT did not differ between the two groups (P = 0.266). The CT increased significantly in Group 1 from pre-operative to first day after surgery (28.1 ± 14.9 in Group 1, and 9.8 ± 15.3 in Group 2) (P < 0.001). The loss in ECC as a percentage was significantly greater in Group 1, 1 day, 1 week and 1 month after surgery (P = 0.18, 0.49 and 0.07, respectively).

The hybrid fragmentation method resulted in less time spent with the phaco being on and with less phaco power. It also caused less loss in ECC and milder changes in CT during the early post-operative time. 50:319-323, 2018. © 2017 Wiley Periodicals, Inc.