Abstract

Objective To compare the clinical efficacy of femtosecond laser-assisted phacoemulsification and traditional phacoemulsification in grade III and grade IV hardness lens nucleus cataract. Methods In this retrospective study, 168 patients (182 eyes) whose nucleus hardness was grade III and grade IV were divided into femtosecond group and traditional group according to different operation methods. Nucleus hardness, cumulative dissipated energy (CDE), best corrected visual acuity (BCVA), corneal endothelial cell density, calculate corneal endothelial cell loss rates, surgically induced astigmatism (SIA), and complications were recorded. Results The BCVA of femtosecond group at 1 week, 1 month and 3 months after operation were better than that in traditional group. For grade III nucleus, the corneal endothelial cell loss rates at 1 month and 3 months after operation of femtosecond group were lower than that in traditional group (P <0.05), for grade IV nucleus, there was no significant difference between the two groups. For grade III nucleus, the CDE value in femtosecond group was reduced by 47.6% than the CDE value in traditional group. For grade IV nu-cleus, the CDE value in femtosecond group was larger than that in traditional group, but there was no significant difference. The SIA value in femtosecond group was less than that in traditional group(P <0.05). Conclusions The postoperative visual acuity of femtosecond laser-assisted phacoemulsification is better than that in traditional phacoemulsification. Femtosecond laser-assisted phacoemulsification led to less surgically induced astigmatism. For grade III nucleus cataract patients, femtosecond laser-assisted phacoemulsification can reduce ultrasonic emulsification energy and lower the injury of corneal endothelial cell. For grade Ⅳ nucleus cataract patients, there is no significant difference in the CDE value and the corneal endothelial cell loss rate between the two operation methods. Key words: Femtosecond laser; Cataract; Phacoemulsification; Corneal endothelium

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