Phacoemulsification and vitrectomy with the erbium:YAG laser and phacoemulsification with the neodymium:YAG laser

There are an increasing number of possible applications for the use of Erbium:YAG and Neodymium:YAG lasers in opthalmology. Laser-phacoemulsification as well as Erbium-laser vitrectomy is of major interest. We report on the underlying technology and more than 1-year-experience using the PHACOLASE (Asclepion-Meditec, Jena, Germany, 10–100 Hz frequency, 5–50 mJ single pulse energy) for phacoemulsification and pars plana vitrectomy and the Lyla-Dodick laser photolysis (A.R.C. Laser, Eckental-Forth, Germany, 1–20 Hz, up to 8 mJ single pulse energy). The Erbium:YAG-laser as well as the Neodymium:YAG-laser enabled us to extract lenses with up to medium hard nuclei. Moreover, the Erbium laser enabled fast vitrectomy with little mechanical traction. In many of our initial surgical operations we had to change to mechanical vitrectomy due to initial technical problems. No new complications occurred intra- or postoperatively. The handpiece worked well in removing vitreous bodies, but was not feasable for cutting membranes. Modified handpieces for this purpose are under development.