Abstract
Purpose The aim of this retrospective cohort study was to evaluate intraocular pressure (IOP) changes during femtosecond laser-assisted cataract surgery (FLACS) using two different patient interface systems. Methods 116 eyes of 116 patients scheduled for cataract surgery were divided into 2 groups: group 1 (61 eyes) and group 2 (55 eyes) underwent FLACS using Catalys Laser with fluid interface (liquid optics interface, LOI) and LenSx Laser with curved interface and soft contact lens (SoftFit), respectively. IOP was assessed using a portable rebound tonometer (Icare®) preoperatively, after docking, immediately after surgery, at one and seven days postoperatively. Results In group 1, the mean IOP (±SD) was 14.1 ± 0.4 mmHg before surgery, 33.2 ± 1.1 mmHg after docking, and 21.4 ± 0.9 mmHg immediately after surgery. In group 2, the mean IOP was 13.8 ± 0.4 mmHg before surgery, 24.2 ± 1.4 mmHg after docking, and 20.2 ± 1.2 mmHg immediately after surgery. After the docking procedure, a statistically significant increase in IOP from the baseline was found in both groups (p < 0.001). Moreover, no statistically significant difference in IOP measured at 1 and 7 days postoperatively was observed compared with the preoperative values (p > 0.05) using both laser platforms. No intraoperative and postoperative complications were observed. Conclusions FLACS suction phase resulted in a transient increase of IOP in both groups, especially with the LOI system, and it is probably related to the greater pressure of a suction ring and suction generated through the vacuum, independently from the effect of femtosecond laser itself.
Highlights
Femtosecond laser technology, firstly introduced as a new technique for creating lamellar flaps in laser-assisted in situ keratomileusis (LASIK) in 2001, has been rapidly developed for cataract surgery, showing several advantages in different surgical steps, such as corneal incisions, anterior capsulotomy, and lens fragmentation [1, 2].All FLACS systems rely on interfaces for the docking phase, which is one of the most delicate steps, allowing good suction and the final success of laser treatment [1]
No statistically significant difference was found between the two groups in terms of clinical cataract grading, preoperative IOP levels, anterior chamber depth, central corneal thickness, and axial length (Table 1)
Group 1 was composed of 61 eyes with a mean age of 72.4 ± 7.6 years, and in group 2, 55 patients with a mean age of 71.5 ± 13.9 years were evaluated
Summary
Femtosecond laser technology, firstly introduced as a new technique for creating lamellar flaps in laser-assisted in situ keratomileusis (LASIK) in 2001, has been rapidly developed for cataract surgery, showing several advantages in different surgical steps, such as corneal incisions, anterior capsulotomy, and lens fragmentation [1, 2].All FLACS systems rely on interfaces for the docking phase, which is one of the most delicate steps, allowing good suction and the final success of laser treatment [1]. Femtosecond laser technology, firstly introduced as a new technique for creating lamellar flaps in laser-assisted in situ keratomileusis (LASIK) in 2001, has been rapidly developed for cataract surgery, showing several advantages in different surgical steps, such as corneal incisions, anterior capsulotomy, and lens fragmentation [1, 2]. E first published studies that compared two different femtosecond lasers have evaluated IOP changes in vivo and ex vivo animal models, describing a higher increase in IOP using the flat applanation interface in comparison with the curved one [5,6,7]. Fluid-filled interfaces have been developed to cope with applanation interface-related rise in IOP and have shown to cause less corneal folds and a lower IOP increase than curved contact lens interface [8]. LOI permits less pressure on Journal of Ophthalmology the cornea as there is no direct force or deformation of the corneal structure [8]
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