Nanosecond Laser Cataract Surgery in LOCS III Grade 4 and 5: A Case Series.

PURPOSE: A major obstacle to the widespread implementation of nanosecond laser cataract removal has been its limited efficacy in cases when the cataract is harder than Lens Opacities Classification System III (LOCS III ) grade 3. The latest technological modifications seem to have overcome this obstacle.

DESIGN: A case series.

METHODS: This study presents a case series of 17 consecutive patients with a cataract classified as harder than LOCS III grade 3 who underwent nanolaser cataract surgery. The basic surgical procedure included administration of topical or local anesthesia, capsulorhexis, hydrodissection, cataract removal with a nanosecond laser, cortical cleanup, intraocular lens implantation, and clear corneal incision closure with physiological solution.

RESULTS: The nanosecond laser system effectively removed the cataract in all patients. This result was statistically significant (P < 0.000001) compared with an expected conversion rate to ultrasound phacoemulsification of 100%.

CONCLUSIONS: Harder cataracts should no longer be considered a limitation for the use of nanosecond laser in cataract surgery.