Comparison of Maximum Stretch Forces between Femtosecond Laser-Assisted Capsulotomy and Continuous Curvilinear Capsulorhexis.

Mari Takagi,Kazuo Ichikawa,Yukihito Kato,Akeno Tamaoki,Yoshiki Tanaka,Rie Horai,Kei Ichikawa,Takashi Kojima

doi:10.1155/2017/3489373

Abstract

The current study reports comparing the postoperative mechanical properties of the anterior capsule between femtosecond laser capsulotomy (FLC) and continuous curvilinear capsulorhexis (CCC) of variable size and shape in porcine eyes. All CCCs were created using capsule forceps. Irregular or eccentric CCCs were also created to simulate real cataract surgery. For FLC, capsulotomies 5.3 mm in diameter were created using the LenSx® (Alcon) platform. Fresh porcine eyes were used in all experiments. The edges of the capsule openings were pulled at a constant speed using two L-shaped jigs. Stretch force and distance were recorded over time, and the maximum values in this regard were defined as those that were recorded when the capsule broke. There was no difference in maximum stretch force between CCC and FLC. There were no differences in circularity between FLC and same-sized CCC. However, same-sized CCC did show significantly higher maximum stretch forces than FLC. Teardrop-shaped CCC showed lower maximum stretch forces than same-sized CCC and FLC. Heart-shaped CCC showed lower maximum stretch forces than same-sized CCC. Conclusively, while capsule edge strength after CCC varied depending on size or irregularities, FLC had the advantage of stable maximum stretch forces.

Highlights

To achieve successful results in contemporary cataract surgery, precise correction of refractive error is essential, especially when toric or multifocal intraocular lenses (IOLs) are implanted
To achieve minimum postoperative refractive error after cataract surgery, it is essential that surgeons accurately predict the effective lens position and axial length [1]
The edges of the capsule openings are often stretched during cataract surgery

Summary

Introduction

To achieve successful results in contemporary cataract surgery, precise correction of refractive error is essential, especially when toric or multifocal intraocular lenses (IOLs) are implanted. To calculate IOL power accurately, it is necessary to precisely predict the postoperative IOL position [1]; in this regard, previous literature has reported that IOL decentration or tilt can increase refractive error by inducing myopic shift or astigmatism [2, 3]. Many techniques have been used to create anterior capsule openings in cataract surgery, for example, continuous curvilinear capsulorhexis (CCC), radiofrequency diathermy, vitrectorhexis, and femtosecond laser-assisted capsulotomy (FLC). Recent studies have indicated that the femtosecond laser can create accurately sized, highly reproducible, and circular capsulotomies [6, 7]

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Results

Conclusion