Abstract
In femtosecond laser-assisted cataract surgery, the parameter such as horizontal spot spacing and energy level can be adjusted. Although there have been several studies reported on various laser systems, showing the effects of varying energy levels and horizontal spot spacing on lens capsulotomy cut edges, none have been reported on the Catalys laser system (Abbott Medical Optics, Inc., Santa Ana, CA). The aim of this study is to evaluate, using scanning electron microscopy (SEM), the quality of the cut edges of the laser lens capsulotomy obtained using the Catalys Laser System, using different horizontal spot spacing and energy levels, and to determine the ideal parameters based on SEM results. Fifty rabbit capsulorhexis specimens from a femtosecond laser with different spot spacing and energy settings were divided into five groups randomly. Spot spacing was 3 um and laser pulse energy was 4 uJ in group 1. The respective values were 5 um and 2 uJ in group 2, 5 um and 4 uJ in group 3, 5 um and 6 uJ in group 4, and 7 um and 4 uJ in group 5. All samples were evaluated using SEM to compare the number of tags per capsulotomy and the laser emission time. Group 1 had a significantly lower tag formation than groups 3 and 5 (P = 0.042 and 0.021, respectively). Although the laser emission time increased about 1.5 sec as the spot spacing increased from 3 to 7 um, the quality of the cut was smoother in group 1 because of overlapping effect of photodisruption cavities. There was no significant difference between groups 2, 3 and 4 at different laser energy settings. In an ex-vivo study, samples from an energy setting of 10 uJ showed increased irregularity and damage. The degree of irregularity was higher at increasing spot spacing and laser energy settings, with abundant tag formation. Dense spot spacing with low-energy settings provide a better cut quality, which is probably correlated with the reduction in anterior capsular tear complications.
Highlights
Femtosecond (FS) laser is a pulsed laser device that emits a laser beam with a short pulse duration in the domain of femtoseconds
We describe the ideal parameters for horizontal spot spacing and laser energy to achieve better microstructural regularity of capsulotomy after FS laser-assisted cataract surgery (FLACS)
Laser emission time for continuous curvilinear capsulorhexis (CCC) 2.57 ± 0.05 1.59 ± 0.03 1.12± 0.04 laser emission time was increased from 1.12 ± 0.04 sec to 2.57 ± 0.05 sec as the spot spacing was decreased to 3 um
Summary
Femtosecond (FS) laser is a pulsed laser device that emits a laser beam with a short pulse duration in the domain of femtoseconds. It operates as a cutting knife by essentially vaporizing tissue. The tightly focused laser energy creates plasma and a cavitation bubble, separating the tissue [1]. Ideal parameters for femtosecond capsulotomy such as horizontal spot spacing or laser energy, within their limitations during preoperative planning. FS laser capsulotomies have been shown to be better centered than manual continuous curvilinear capsulorhexis (CCC), with highly predictable sizes [2,3,4]
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