Differing methods, similar inflammation

San Francisco-Whether a surgeon uses a laser for cataract surgery or manual methods may not make much of a difference in terms of postoperative inflammation.

That at least is the experience of H. Burkhard Dick, MD, professor and chairman of ophthalmology and director of the University Eye Clinic Bochum, Bochum, Germany. Data presented showed significantly less ocular inflammation in patients who had laser surgery the day after the procedure compared with manual cataract surgery. But there was no difference in inflammation between the two groups on days 3 or 7.

Researchers compared inflammation rates and other surgical parameters as part of a randomized prospective trial on 152 eyes and 76 patients. Dr. Dick performed all of the cataract surgeries, capsulotomy, and fragmentation either by manual methods or using a laser system (Catalys, OptiMedica) with a fluid-filled interface and three-dimensional optical coherence tomography image guidance.

The biggest difference between the manual and laser surgeries was the effective phacoemulsification time (EPT). Laser procedures were much faster, typically less than 1 second EPT compared with several seconds for the manual procedure, Dr. Dick noted.

Inflammation results were much less concrete. On day one following surgery, the laser group had statistically significantly lower inflammation, 15.9 photon counts/msec, compared with the manual surgery group, 19.7 photon counts/msec, a 19 percent difference (p = 0.008). But the laser flare values were not statistically different from the manual flare values on days 3 or 7 following surgery (p > 0.05 for both days).

“The laser surgery group had a reduction in ultrasound energy and less inflammation on day 1,” Dr. Dick said. “Inflammation on days 3 and 7 was no higher in patients who had manual surgery, but it was no lower, either.”

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