This image-guided femtosecond laser technique enables precise capsulorrhexis enlargement which results is a 360° overlap of the IOL optic. An image-guided femtosecond laser technique is an option for enlarging or customizing a small anterior capsulorrhexis. A small capsulorrhexis can cause capsular bag shrinkage, IOL decentration or tilt and patient dissatisfaction. Manual capsulorrhexis enlargement techniques are challenging and frequently yield unsatisfactory results, according to the study authors.
This femtosecond laser technique (published in the Journal of Cataract and Refractive Surgery) is performed with the Catalys Precision Laser System (Abbott Medical Optics, Santa ana, USA) in eyes whose capsulorrhexis was smaller than 4 mm. All patients received an IOL that was 6 mm in diameter.
The technique offers the advantages of a laser-generated capsulotomy: perfection of laser-generated capsulotomy in size, position aligned to the individual IOL optic location, and circularity and shape in a closed system.
The system’s three-dimensional spectral-domain optical coherence tomography feature is used to visualize the anterior segment. Using the infrared camera, the anterior rescue capsulotomy is centered manually on the IOL. In the axial and sagittal OCT view, the opened anterior capsule is identified and the treatment zone is adjusted. This technique also takes into account any tilt of the eye or the IOL and positions the capsulotomy accordingly because of the 3-D SD-OCT. The technique slightly increases time by a minute up to a minute and a half because of the need to re-dock and re-scan. Time for cutting the capsulotomy is about 2 seconds maximum.
The laser-assisted technique will be applicable to future IOL designs that might incorporate new shapes or features, such as bumps in the capsulotomy edge for alignment or IOL fixation, that cannot be accommodated manually. The technique can be performed before or after IOL implantation and has other advantages. Especially after IOL implantation, it takes into account the individual position of the IOL in the capsular bag, which sometimes is not the geometric center of the capsular bag. Therefore, 360° capsular overlap is guaranteed. If the IOL has to be positioned at a certain location as in a toric IOL alignment to the axis, the IOL still would be covered completely.
Capsulotomy/Capsulorrhexis • Cataract • Cataract Surgery • Femtosecond Laser Refractive Cataract Surgery • Refractive Surgery