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Laser plus phaco for dense cataracts enhances safety, visual outcomes
Removing extremely dense cataracts can often be traumatic to the corneal endothelium due to the increased amount of phacoemulsification energy required to break up tough nuclei. The resulting edema can have a significant impact on corneal health, lasting from days to weeks after surgery. If these patients have underlying endothelial disease such as Fuchs’ dystrophy with an already borderline endothelium, cataract removal can cause full corneal decompensation. It has been well accepted that laser nuclear fragmentation significantly decreases the amount of phacoemulsification energy