Laser-aspiration method of lens surgery without ultrasound energy in patients with refractive anomalies, presbyopia or medium-density cataract. Previous results
Authors:   Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russian Federation, Arakelyan D.E. , Arutyunyan L.L. ,   Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russian Federation, Kopaev S.Y. ,   Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russian Federation,   Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russian Federation, Kechin E.V. ,   Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russian Federation,   Russian Medical Academy of Continuous Professional Education, Moscow, Russian Federation
Published: February 2025

Purpose. To analyze the possibilities and present primary results of the study on the using of laser-aspiration method of lens surgery in patients with refractive anomalies, presbyopia and medium-density cataract without using ultrasound energy.

Material and methods. The study included 30 patients (40 eyes), 15 patients in each study group, mean age 55.8±10.3 years. The criteria for inclusion: patients with refractive anomalies for whom corneal surgery was not indicated, presbyopia or cataract of 1–3rd degree according to Buratto L. classification. Patients with serious ocular or systemic diseases, as well as with cataract of the 4–5th degree were excluded. The patients of the main group performed aspiration of lens masses with the ultrasoundfree irrigation-aspiration handle after femtosecond fragmentation of the dense part of the lens, the patients of the control group received standard phacoemulsification. Before the operation and in dynamics all patients performed standard and extended ophthalmologic examination, including endothelial microscopy, optical coherence tomography of the posterior segment of the eye, tonography, pachymetry; optical biometry and densitometric analysis of the lens were also performed before the operation. Intraoperatively we evaluated hydrodynamic parameters of surgery and viscoelastic safety. For subjective assessment of the quality of vision we used the Visual Function-14 questionnaire, an additional structured questionnaire was used to assess the level of patient satisfaction.

Results. The postoperative period in both groups passed without complications. We found achievement of refractive target and absence of corneal edema on the next day after surgery. Insignificant loss of endothelial cells and minimal phenomena of polymegitism after 6 months. Intraocular pressure changes in reference values. Aspiration time and amount of fluid used in the main group is significantly less than in the control group. Satisfaction analysis: high marks in the main group for the quality of vision and rehabilitation. In the control group — for the time of surgery and accessibility of the method.

Conclusion. Supplanting one type of energy with another, the laser-aspiration method is preferable due to the standardization of steps, less traumatism, high refractive result on the next day and fast rehabilitation despite the financial and time costs. Positive feedback confirms the improvement of visual function and overall quality of life.

Key words: refractive lens surgery, laser-aspiration method, ultrasound-free handle, presbyopia, cataract, refractive anomalies, femtosecond laser, densitometry, Scheimpflug camera, statistical analysis, patient satisfaction survey.