Abstract
Several recent reports have discussed the potential benefits of using the Nd:YAG laser to photofragment the nucleus prior to cataract extraction. We attempted to determine the efficacy and safety of photophacofragmentation prior to cataract surgery. We selected 32 patients for the laser photofragmentation category and 37 patients for the control group. We compared these patients with both phacoemulsification and extracapsular cataract extraction. There was no apparent difference between the four subgroups in endothelial cell loss postoperatively. There was a significant decrease in the amount of ultrasonic time required to remove the cataract for patients who had prior treatment with the YAG laser. However, although this was statistically significant, it did not alter the patient's total surgical time nor the outcome of surgery. We feel that photophacofragmentation introduces needless increased risk to the patient and recommend guarded use of this approach.
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