Laser cataract surgery : A prospective clinical evaluation of 1000 consecutive laser cataract procedures using the Dodick photolysis Nd:YAG system.

BACKGROUND To evaluate the safety and efficacy associated with the clinical use of a Q-switched neodymium:yttrium-aluminum-garnet (ND:YAG) laser for cataract removal. DESIGN Multicenter, prospective, noncomparative case series. PARTICIPANTS/INTERVENTION A total of 1000 consecutive eyes underwent cataract extraction with the photolysis Q-switched ND:YAG laser at 12 international clinical sites. MAIN OUTCOME MEASURES Visual acuity improvement; total energy used; mean operative time for cataract removal; complications, both intraoperative and postoperative; with a minimum follow-up of 3 months. RESULTS The mean values were visual acuity improvement from 20/70.2 to 20/24.4. Mean intraocular energy used was 5.65 J per case. Mean operative photolysis time among the surgeons was for up to +1 nuclear sclerosis, 2.15 minutes; up to +2 nuclear sclerosis, 4.8 minutes; and for up to +3 nuclear sclerosis, 9.8 minutes. Three cases were completed by intraocular lens implantation through the original sub-2-mm incision, using a prefolded, by dehydration, acrylic intraocular lens. Minor complications were encountered in 18 cases. CONCLUSIONS These data suggest this photolysis laser technology may be a safe and effective alternative for cataract extraction in human eyes. By use of small clear cornea incisions, the ability to perform cataract extraction and intraocular lens implantation with incisions less than 2 mm has been shown for the first time.