Erbium : YAG laser emulsification of the cataractous lens

Purpose. To evaluate the clinical effectiveness and safety of the erbium:YA G (Er:YAG) laser for cataract extraction surgery. Setting. Visual Sciences Institute, Madrid, Spain. Methods: In this prospective randomized study, 65 eyes of 50 patients sched uled for cataract extraction were divided into 2 groups based on the type o f lens emulsification: Er:YAG laser (40 eyes) or ultrasound (US) (25 eyes). The laser procedure was converted to the US technique in cases with potent ial complications. All patients received a foldable posterior chamber intra ocular lens. A complete ophthalmologic examination including topographic an alysis, pachymetry, and endothelial cell count was performed preoperatively and 1 day, 2 weeks, and 1, 3, 6, and 12 months postoperatively. All patien ts had fluorescein angiography at 1 month to rule out subclinical cystoid m acular edema (CME). Results: There were no significant differences between the techniques in an y parameter at any time. In both groups, visual acuity significantly increa sed and endothelial cell count significantly decreased postoperatively (P < .01). The only serious complication was subclinical CME in 2 patients 1 mo nth after the laser procedure. Conclusions. Emulsification of the lens using the Er:YAG laser was effectiv e for performing small incision cataract surgery in eyes with soft and medi um nuclei. The small ablation zones created can help prevent damage to surr ounding ocular structures. The Er:YAG technique used less ablation energy t han US emulsification and did not result in thermal injury. (C) 2001 ASCRS and ESCRS.