Intraocular lens tilt and decentration after Nd:YAG laser posterior capsulotomy: Femtosecond laser capsulorhexis versus manual capsulorhexis

Çınar, Esat; Yüce, Berna; Aslan, Fatih; Erbakan, Gökhan; Küçükerdönmez, Cem

doi:10.1016/j.jcrs.2019.07.017

Cited by 14 publications

(10 citation statements)

References 32 publications

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“…In general, we found that femtosecond laser capsulotomy has better parameters of capsulorrhexis and caspule-IOL overlap, which included the capsulorrhexis area being more precise and the complete overlap ratio being superior to compared manual capsulotomy. These results are all supported by previous studies (20) and are consistent with those seen in common cataracts (22,23). However, there is no significant difference in the circularity of the 2 types of capsulotomy in this study.…”

Section: Discussionsupporting

confidence: 93%

Parameters of Capsulorrhexis and Intraocular Lens Decentration After Femtosecond and Manual Capsulotomies in High Myopic Patients With Cataracts

et al. 2021

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Purpose: To compare the parameters of capsulorrhexis and intraocular lens decentration after femtosecond laser capsulotomy and manual continuous curvilinear capsulorrhexis in high myopic patients with cataracts.Methods: This is a prospective consecutive non-randomized comparative cohort study. Selected patients with axial length > 26.0 mm were divided into femtosecond laser capsulotomy (FS) group and manual continuous curvilinear capsulorrhexis (CCC) group. Five experienced phacoemulsification surgeons conducted all surgeries. Intraoperative complications and post-operative anterior segment photography were recorded. Intraocular lens decentration, area of capsulorrhexis, circularity, and capsule overlap were measured at 1 week, 1 month, and 2 years after surgery. Between group differences of parameters were determined with independent-sample t-test or the Mann–Whitney U-test, analysis of variance test, Pearson chi-square test, and Spearman rank correlation test.Results: The study included 142 eyes (108 patients), 68 eyes in the FS group, and 74 eyes in the CCC group. At 1 week, 1 month, and 2 years after surgery, the area of capsulorrhexis in the CCC group was significantly larger than in the FS group (P < 0.05), while no significant difference was noted in circularity values. The complete overlap ratio in the FS group was significantly higher than that in the CCC group (P < 0.05) at each measured timepoint. Significant correlations were noted between the anterior chamber depth and the area of capsulorrhexis in the CCC group (R = 0.25, P = 0.04), but did not correlate in the FS group (P > 0.05). In patients with an anterior chamber depth >3 mm, the capsule-intraocular lens (IOL) overlap of the CCC group was less than that of the FS group at all measured timepoints after surgery (P < 0.05). Meanwhile, the IOL decentration in the CCC group was significantly greater than that of the FS group in those patients at 2 years after surgery (P < 0.05).Conclusion: In high myopic patients with cataracts, with anterior chamber depth more than 3 mm, femtosecond laser capsulotomy can achieve better capsulorrhexis sizing and centering. Due to more precise capsulotomy and a better capsule-IOL overlap in the FS group, femtosecond laser capsulotomy resulted in better long-term centration of the IOL.

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Section: Discussionsupporting

confidence: 93%

Parameters of Capsulorrhexis and Intraocular Lens Decentration After Femtosecond and Manual Capsulotomies in High Myopic Patients With Cataracts

et al. 2021

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“…The femtosecond laser capsulorhexis group resulted in better mechanical stability of the IOL, due to better maintenance of the correct position of the IOL. Although the differences in groups were statistically significant, the tilt and decentration values were small and not clinically significant, as in our study 12 . Zafer Oztas 13 reported significantly increased ACD after Nd:YAG surgery.…”

Section: Discussioncontrasting

confidence: 60%

Changes of intraocular lens position induced by Nd:YAG capsulotomy

Fus

Pitrová

Marešová³

et al. 2022

BIOMED PAP

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The aim of this study was to evaluate the changes in IOL position (axial shift, tilt and decentration) in the capsular bag after Nd:YAG laser capsulotomy and to create a user-friendly software that is optimized for the output of available imaging technology, then verify the relationship between the biometric parameters of the eye and the extent of changes in the IOL position. Patients and Methods. The study included 35 artephakic eyes that underwent laser capsulotomy. Before and at least one hour after capsulotomy, all patients underwent the following assessments: optical biometry (Lenstar LS900), OCT with anterior segment module (Optovue Avanti) and IOL photography in infrared mode using reference unit (Verion). The original software solution was designed for the graphical evaluation of the differences between centering, axial displacement and tilt of IOL. Changes in IOL position were evaluated as simple differences before and after the laser procedure and as differences in absolute values (abs). Results. The following results show the average differences in IOL position: ACD=0.02±0.23 mm (abs=0.11±0.20 mm), IOL decentration in x-axis =-0.001±0.091 mm (abs=0.065±0.063 mm), IOL decentration in y-axis =0.012±0.119 mm (abs=0.048±0.53 mm), tilt in horizontal plane TILT-H=0.11±0.83° (abs=0.51±0.66°) and tilt in vertical plane TILT-V =-0.14±0.49° (abs=0.26±0.44°). All changes were insignificant (P>>0.05). In total, 74.29% of IOLs showed a hypermetropic shift. A moderate positive correlation was found between the absolute differences in horizontal tilt and keratometry (r=0.45). Relationship with other changes and parameters were weak. Conclusion. In conclusion, the use of the original software solution developed by the authors showed that changes in IOL centering, axial displacement and tilt occur after Nd:YAG capsulotomy, but average differences were insignificant. In almost 3/4 cases, there was a hypermetropic axial displacement of the IOL.

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“…Statistically significant TIOL rotation was found 1 month after Nd:YAG capsulotomy along with a significant decrease in IOL tilt coupled with a significant decentration of the TIOL ( P < .05). 1 Although we agree with the authors that the degree of TIOL rotation was not clinically significant as the spherical equivalence (SE) before and after Nd:YAG capsulotomy was similar ( P = .352), we have several concerns with the study.…”

supporting

confidence: 79%

“…We commend Cinar et al on their unique and interesting study regarding Nd:YAG laser capsulotomy on toric intraocular lens (TIOL) rotation. 1 Cinar et al performed a retrospective study from January 2017 to September 2022 involving uneventful cataract surgery with implantation of a TIOL (AcrySof IQ SN6ATX); TIOL orientation, tilt, and decentration were measured 1 month before and after capsulotomy using an iTrace aberrometer and Scheimpflug imaging. Statistically significant TIOL rotation was found 1 month after Nd:YAG capsulotomy along with a significant decrease in IOL tilt coupled with a significant decentration of the TIOL ( P < .05).…”

mentioning

confidence: 99%

Comment on: Influence of Nd:YAG laser capsulotomy on toric intraocular lens rotation and change in cylinder power

LoBue,

Martin,

Shelby

et al. 2024

J Cataract Refract Surg

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Intraocular lens tilt and decentration after Nd:YAG laser posterior capsulotomy: Femtosecond laser capsulorhexis versus manual capsulorhexis

Cited by 14 publications

References 32 publications

Parameters of Capsulorrhexis and Intraocular Lens Decentration After Femtosecond and Manual Capsulotomies in High Myopic Patients With Cataracts

Parameters of Capsulorrhexis and Intraocular Lens Decentration After Femtosecond and Manual Capsulotomies in High Myopic Patients With Cataracts

Changes of intraocular lens position induced by Nd:YAG capsulotomy

Comment on: Influence of Nd:YAG laser capsulotomy on toric intraocular lens rotation and change in cylinder power

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