Differences in energy expenditure for conventional and femtosecond-assisted cataract surgery using 2 different phacoemulsification systems

Abstract

To compare the mean cumulative dissipated energy (CDE) in patients having femtosecond laser-assisted or conventional phacoemulsification cataract surgery using 2 different phacoemulsification platforms. Bascom Palmer Eye Institute, Miami, Florida, USA. Prospective comparative nonrandomized clinical study. Consecutive patients were scheduled to have femtosecond laser-assisted cataract surgery with the Lensx laser or conventional phacoemulsification using an active-fluidics torsional platform (Centurion) or torsional platform (Infiniti). The mean CDE and cataract grade were recorded. The study comprised 570 eyes (570 patients). There was no statistically significant difference in mean age (P=.41, femtosecond group; P=.33, conventional group) or cataract grade (P=.78 and P=.45, respectively) between the active-fluidics and gravity-fluidics platforms. In femtosecond cases (145 eyes), the mean CDE (percent-seconds) was 5.18±4.58 (SD) with active fluidics and 7.00±6.85 with gravity fluidics; in conventional cases (425 eyes), the mean CDE was 7.77±6.97 and 11.43±9.12, respectively. In both femtosecond cases and conventional cases, the CDE was lower with the active-fluidics platform than with the gravity-fluidics platform (P=.029, femtosecond group; P<.001 conventional group). With both fluidics platforms, the mean CDE was significantly lower in the femtosecond group than in the conventional group (both P<.001). The active-fluidics phacoemulsification platform achieved lower CDE values than the gravity-fluidics platform for conventional cataract extraction. Femtosecond laser pretreatment with the active-fluidics platform further reduced CDE.