An exploration of safe and efficient nucleus fragmentation strategies for femtosecond laser-assisted cataract surgery in short axial length patients.

Abstract

<h4>Purepose</h4>The intraoperative femtosecond laser time, Cumulative Dissipated Energy (CDE), Effective Phacoemulsification time (EPT), and intraoperative fluid perfusion volume were compared under different model fragmentation modes using Catalys femtosecond laser system.<h4>Methods</h4>This was a single-center, prospective, randomized controlled study. A total of 120 eyes who underwent femtosecond laser-assisted cataract phacoemulsification combined with intraocular lens implantation in Xiamen Eye Center affiliated to Xiamen University from September 2022 to March 2023 were randomly divided into 4 groups to undergo pre-nucleus splitting in different ways: Group 1: six-split, Group 2: eight-split, Group 3: six-split + gridded softening, and Group 4: eight-split + gridded softening. Patient age, gender, LOCS III grade, intraoperative femtosecond laser time, CDE, EPT, and intraoperative fluid perfusion volume were collected and analyzed.<h4>Result</h4>Result SNK test and Bonferroni test showed no significant difference in the nuclear hardness of lens, age, gender, AL, ACD, WTW and LT among the four groups (P > 0.05). Femtosecond laser time: Group 1: 44.87 ± 21.08s; Group 2: 43.10 ± 16.57s; Group 3: 50.70 ± 17.30s; Group 4: 64.04 ± 30.08s. There was no significantly different among groups 1, 2 and 3 (P > 0.05). However, the difference between group 4 and Group 1&2 was statistically significant (P_1.4= 0.006, P_2.4=0.00 2). There were no significant differences in CDE, EPT, and fluid perfusion between the four groups.<h4>Conclusions</h4>Short axial length patients may benefit more from the Catalys femtosecond laser system's six or eight-split nucleus mode Settings, which produce the same or even more effective pre-split treatment than the mesh softening mode while using less femtosecond laser time.