title: Femtosecond laser-assisted compared with standard cataract surgery for removal of advanced cataracts.
abstract: OBJECTIVE
  To compare effective phacoemulsification time (EPT) for the removal of brunescent cataracts treated with femtosecond laser-assisted cataract surgery with standard cataract phacoemulsification techniques.
  
  
  METHODS
  Ruhr University Eye Hospital, Bochum, Germany.
  
  
  METHODS
  Comparative prospective case study.
  
  
  METHODS
  The Lens Opacities Classification System III (LOCS III) grading system was used to measure eyes divided into 4 groups having cataract surgery. Groups 1 and 2 contained eyes with LOCS III grade nuclear opalescence (NO) 3 cataracts treated with standard cataract surgery and femtosecond laser-assisted cataract surgery, respectively. Groups 3 and 4 contained brunescent cataracts, LOCS III grades NO5, treated with standard cataract surgery and femtosecond laser-assisted cataract surgery, respectively.
  
  
  RESULTS
  There were 240 eyes, with 60 eyes in each group. The EPT in Group 1 ranged from 0.46 to 3.10 (mean 1.38); the EPT in all eyes in Group 2 was 0 (P < .001). The EPT in Groups 3 and 4 was 2.12 to 19.29 (mean 6.85) and 0 to 6.75 (mean 1.35), respectively (P < .001). A comparison between EPT in Groups 1 and 4 showed that EPT in Group 4 was also lower than in Group 1 (P = .013). Groups 4 and 1 were the most statistically similar of all groups compared, suggesting that EPT for a femtosecond laser-treated grade 5 cataract was most similar to that of a standard-treated grade 3 cataract.
  
  
  CONCLUSIONS
  Femtosecond laser pretreatment for brunescent cataracts allowed for a significant reduction in EPT compared with manual standard phacoemulsification techniques.
  
  
  BACKGROUND
  Drs. Hatch, Talamo, and Dick are consultants to Abbott Medical Optics, Inc. Dr. Schultz has no financial or proprietary interest in any material or method mentioned.
authors.affiliation: From the Department of Ophthalmology (Hatch, Talamo), Harvard Medical School and Massachusetts Eye and Ear Infirmary, Waltham, Massachusetts, USA; the Institute of Vision Science (Schultz, Dick), Ruhr University Eye Hospital, Bochum, Germany. Electronic address: kathryn_hatch@meei.harvard.edu.
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Hatch
authors.affiliation: From the Department of Ophthalmology (Hatch, Talamo), Harvard Medical School and Massachusetts Eye and Ear Infirmary, Waltham, Massachusetts, USA; the Institute of Vision Science (Schultz, Dick), Ruhr University Eye Hospital, Bochum, Germany.
authors.forename: Tim
authors.initials: T
authors.lastname: Schultz
authors.affiliation: From the Department of Ophthalmology (Hatch, Talamo), Harvard Medical School and Massachusetts Eye and Ear Infirmary, Waltham, Massachusetts, USA; the Institute of Vision Science (Schultz, Dick), Ruhr University Eye Hospital, Bochum, Germany.
authors.forename: Jonathan H
authors.initials: JH
authors.lastname: Talamo
authors.affiliation: From the Department of Ophthalmology (Hatch, Talamo), Harvard Medical School and Massachusetts Eye and Ear Infirmary, Waltham, Massachusetts, USA; the Institute of Vision Science (Schultz, Dick), Ruhr University Eye Hospital, Bochum, Germany.
authors.forename: H Burkhard
authors.initials: HB
authors.lastname: Dick
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000145:classification; D002387:Cataract Extraction; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D018918:Phacoemulsification / Q000379:methods*; D011446:Prospective Studies; D019591:Pseudophakia / Q000503:physiopathology; D012029:Refraction, Ocular / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology