Peri- and post-operative inflammation and the intraocular effects, caused by surgical trauma, remain important issues in cataract surgery. Several factors are known to be inducers of inflammatory responses, both in manual and Femto-cataract surgery. Surgical trauma, ultrasound waves, intra-ocular manipulations, laser cavitation bubbles, and suction induce irritation of the ciliary body. The ciliary body reacts by producing prostaglandins and other inflammatory mediators.

Production of inflammatory mediators with the nanojoule FEMTO LDV Z8 is the lowest reported in the literature among all systems on the market.

Peri-operatively, the prostaglandins cause pupil miosis and lead to potential difficulties during the operation. Postoperatively, the inflammation causes pain and slows down patients’ return to everyday activities. Anterior chamber flare and corneal swelling are known to influence visual recovery. This becomes more important than ever before, as younger patients are now also undergoing cataract surgery for refractive reasons. With today`s fast-paced lifestyle demands, younger people are eager to return to their workplaces without the hassle of taking pain medication or not being able to see well.

Due to its superior precision, refractive cataract patients mostly opt for Femto-laser treatment [5], [6], [2]. The laser pre-fragmentation of a cataractous lens uses less ultrasound, needed for cataractous lens removal. Also, the intra-ocular manipulations are reduced, thanks to both the laser lens fragmentation and laser capsulotomy. Thus, the effect of surgical trauma can be decreased.

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Conclusions

  1. Production of inflammatory mediators with the nanojoule FEMTO LDV Z8 is the lowest reported in the literature among all systems on the market.
  2. No clinical evidence of significant pupil diameter changes with the FEMTO LDV Z8 was reported. The PG E2, involved in pupil constriction, showed the lowest values.
  3. IL – 1 and IL – 6, responsible for the macular edema, PCO formation, and pain, presented the lowest numbers with the FEMTO LDV Z8.
  4. The central corneal thickness returns to preoperative values at 1-week post-op. This ensures fast visual recovery when using the low energy laser.
  5. A combination of mydriatic drops and NSAIDs is recommended to ensure sufficient mydriasis, as well as to suppress the production of inflammatory mediators.