الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
The aim of this work is to compare safety and efficacy between ultrasonic phacoemulsification and Erbium YAG laser phacolysis cataract surgery using these parameters: Visual outcome, Corneal endothelial cell loss using specular microscopy, Intraoperative time, Postoperative and surgically induced astigmatism, Intraoperative and postoperative complications. Subjects and Methods: This study was conducted on 117 patients (120 eyes) who were diagnosed as cataract with grade 3 nuclear density maximally who were selected from patients attending the ophthalmic outpatient clinic of Mansoura Ophthalmology Center. The selected patients were divided randomly into two groups. Group I: included 60 eyes that underwent ultrasound phacoemulsification and foldable PCIOLs, Group II: included 60 eyes that underwent laser phacolysis and foldable PCIOLs. Full ophthalmological examination was done including BCVA, slit lamp biomicroscopy, refraction, intraocular pressure measurement, posterior segment examination, A and B scan ultrasonography, Corneal astigmatism, Central endothelial cell count. Results: There was no statistically significant difference at all postoperative intervals between both groups in the following: BCVA, IOP, central endothelial cell count, percentage of endothelial cell loss, surgically induced astigmatism. Percentage of endothelial cell loss was significantly increasing within each group with postoperative time. There was a marked statistically significant difference between both groups in the consumed intraoperative time. There was a gradual increase in the percentage of endothelial cell loss directly related to the increase in the grade of the nuclei and it was highly statistically significant. Conclusions: The advantages of erbium: YAG laser are: Equal visual outcome to that of ultrasound, Decreased thermal effects with decreased incidence of wound burn than ultrasound, Proved safety on corneal endothelial cells equal to that of ultrasound, Reduced rate of posterior capsule rupture with working even in close proximity to it which is better than ultrasound phacoemulsification. The disadvantages are: Limitations to moderate density nuclear hardness on which ultrasound can act effectively and rapidly, Longer time consumption in comparison to ultrasound working on similar nuclear grades.