September 18, 2023
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Hoffmann S, et al. Femtosecond laser-assisted mini-capsulotomy for intumescent white cataracts. Provided at: European Society of Cataract and Refractive Cosmetic surgeons conference; Sept. 8-12, 2023; Vienna.
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Disclosures:
. Hoffmann reports no appropriate monetary disclosures.
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VIENNA– A two-step femtosecond laser-assisted strategy provides a safe method of carrying out capsulotomy in intumescent cataract, preventing intraoperative problems.
” Intumescent cataract is a huge obstacle since you have no red reflex, you have a greater intralenticular pressure and likewise fluid leaving the lens, that makes the vision fuzzy,” Sebastian Hoffmann, MD, stated at the European Society of Cataract and Refractive Cosmetic surgeons conference.
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Intumescent cataract surgical treatment has a raised issue profile, with a high threat for anterior capsular tear and Argentinian flag indication, which can likewise cause posterior capsular tear, zonulolysis, vitreous loss and IOL decentration.
Sebastian Hoffmann
The unique strategy established at the University of Bochum, Germany, requires the development of a 2 mm size mini-capsulotomy with the femtosecond laser to launch the intralenticular pressure. This is followed by the elimination of pill pieces with trypan blue and injection of an ophthalmic viscosurgical gadget (OVD) to support the anterior chamber.
” Then you exchange the OVD and fluid that left the lens with [balanced salt solution], and you can do a redocking and a 2nd femto capsulotomy without pressure, or you can likewise do a typical capsulorrhexis and after that continue with the basic cataract surgical treatment,” Hoffmann stated.
The mini-capsulotomy treatment is quickly, he stated, with just 0.4 seconds of laser time, an overall energy of 0.2 J to 0.3 J, and a pulse energy of 4 µJ.
This strategy was utilized in 53 eyes with intumescent cataract from 2012 to May 2023. While carrying out the capsulotomy, an explosive discharge of lens product might be observed in all cases. The 2nd capsulotomy was carried out with the femtosecond laser in 31 eyes and by hand in 22 eyes.
” If you do the 2nd capsulotomy with the femtosecond laser, you need to redock, and it’s usually really simple and manageable,” Hoffmann stated.
Outcomes were great and permitted IOL implantation in the capsular bag in all cases. There were no cases of posterior pill tears and no Argentinian flag indication. Anterior pill tears happened in 2 cases however were not associated with the strategy, Hoffmann stated. One case was because of an application mistake throughout the 2nd capsulotomy and one to head motion of the client throughout phacoemulsification.
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