Comparison of the Mechanical Properties of the Anterior Lens Capsule Following Manual Capsulorhexis and Femtosecond Laser Capsulotomy

Sándor, Gábor László; Kiss, Zoltán; Bocskai, Zoltán; Kolev, Krasimir; Takács, Ágnes; Juhász, Éva; Kránitz, Kinga; Tóth, Gábor; Gyenes, Andrea; Bojtár, Imre; Juhász, Tibor; Nagy, Zoltán Zsolt

doi:10.3928/1081597x-20140903-08

Cited by 33 publications

(21 citation statements)

References 11 publications

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“…Femtosecond laser‐assisted capsulotomy had less average resistance to capsule tear than manual capsulorhexis, and a capsulotomy created at a high laser energy was slightly weaker and less extensible than that created at low or intermediate levels in ex vivo porcine possibly due to the increased thermal effect (Sándor et al. , ). The respiratory movement of the eye during femtosecond laser‐assisted capsulotomy was speculated as a potential risk factor for redial capsule tear (Schultz et al.…”

Section: Discussionmentioning

confidence: 99%

Safety of femtosecond laser‐assisted cataract surgery: assessment of aqueous humour and lens capsule

Chen

Wang

et al. 2016

Acta Ophthalmologica

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Section: Discussionmentioning

confidence: 99%

Safety of femtosecond laser‐assisted cataract surgery: assessment of aqueous humour and lens capsule

Chen

Wang

et al. 2016

Acta Ophthalmologica

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“…This is important as IOLs are typically positioned in the lens bag by folding or injecting and must therefore resist forces that could lead to rupture. The morphology of FLACS capsulotomy edges, characterized by a more serrated appearance compared to manual capsulorhexis when viewed at high magnification (>×2000) may play a role in vulnerability to tags and tears 20 21 22 . It is perhaps surprising therefore that the existing literature suggest that many of the femtosecond laser platforms compare favorably to, but also exhibit high mechanical strength compared to manual rhexis ( Table 1 ) 13 15 16 17 18 .…”

mentioning

confidence: 99%

The effects of a low-energy, high frequency liquid optic interface femtosecond laser system on lens capsulotomy

Williams

George

Wong

et al. 2016

Sci Rep

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The introduction of femtosecond laser assisted cataract surgery (FLACS) is a paradigm changing approach in cataract surgery, the most commonly performed surgical procedure. FLACS has the potential to optimize the creation of an anterior lens capsulotomy, a critical step in accessing the cataractous lens. The merits of using a laser instead of a manual approach include a potentially more circular, consistent, and stronger aperture. In this study we demonstrated for the first time in both a porcine and human experimental setting that with a low energy, high repetition FLACS system, that a circular, smooth and strong capsulotomy was achievable. While there was no demonstrable difference in the resistance to rupture before or after the removal of the nucleus, larger capsulotomies had an increase in tensile strength. The LDV Z8 system appeared to create circular, rupture-resistant and smooth capsulotomies in both porcine and more importantly human globes.

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“…Cystotome and forceps are two of the most commonly used instruments for a CCC, despite the rise of femtosecond laser assisted capsulorhexis [ 2 – 4 ]. According to previously published results in a porcine eye model, femtosecond laser assisted capsulorhexis had less average resistance to capsule tear than CCC because the edge of the anterior capsule opening made by femtosecond laser was not as smooth as that made manually [ 5 ]. The advantages of using a cystotome to create a capsulorhexis compared to a pair of forceps include less corneal wound distortion, better view of the capsulorhexis edge, and minimal inadvertent loss of the viscoelastic agent.…”

Section: Introductionmentioning

confidence: 99%

Continuous Curvilinear Capsulorhexis in Cataract Surgery Using a Modified 3-Bend Cystotome

Zeng

Gao

2015

Journal of Ophthalmology

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We modified a 2-bend cystotome for continuous curvilinear capsulorhexis (CCC) in manual or phacoemulsification cataract surgery to improve the safety and ease of performance. A 26G needle was converted into a cystotome with 3 bends. In this retrospective study, the performance of modified 3-bend cystotome was compared with conventional 2-bend cystotome. During cataract surgery, in the 3-bend cystotome group, mean completion time of CCC was shorter, mean times of viscoelastic agent supplement were less, and CCC success rate was higher than that in 2-bend group. Complication incidence, such as postoperative transient corneal edema and irreparable V-shaped tear, was also lower in 3-bend group. No posterior capsular rupture or no other complication was observed in either group. A polymethyl methacrylate intraocular lens or a hydrogel intraocular lens was implanted in the capsular bag in all eyes. We conclude that it is safe and efficient to accomplish a CCC using the 3-bend cystotome due to its ability to sustain the anterior chamber depth (ACD) and keep the posterior lip intact. Using the 3-bend cystotome also allowed for an adequate view into the anterior chamber from lack of wound deformation.

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Comparison of the Mechanical Properties of the Anterior Lens Capsule Following Manual Capsulorhexis and Femtosecond Laser Capsulotomy

Abstract: According to the current results in a porcine eye model, FLC had less average resistance to capsule tear than CCC, but the weakest openings were seen in the CCC group.

Cited by 33 publications

References 11 publications

Safety of femtosecond laser‐assisted cataract surgery: assessment of aqueous humour and lens capsule

Safety of femtosecond laser‐assisted cataract surgery: assessment of aqueous humour and lens capsule

The effects of a low-energy, high frequency liquid optic interface femtosecond laser system on lens capsulotomy

Continuous Curvilinear Capsulorhexis in Cataract Surgery Using a Modified 3-Bend Cystotome

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