Posters

Clinical experience using the LDV Z8 system for femtolaser-assisted cataract surgery in a public service setting

Poster Details

First Author: F. Allen UNITED KINGDOM

Co Author(s):    A. Garg   V. Barnett   A. Barsam              

Abstract Details

Purpose:

Over 300,000 cataract surgeries are performed every year in NHS England. There is growing interest in using femtosecond laser to improve efficiency and safety. The femtosecond laser can be used to perform corneal incisions, anterior capsulotomy and lens fragmentation. The intricate and step-wise nature of cataract surgery means that one step can influence the rest of the operation. An unstable or incorrectly sized anterior capsulotomy increases the likeliness of surgical complications. We report on our clinical experience of performing capsulotomy using the mobile Zeimer LDV Z8 system designed for corneal and cataract surgery.

Setting:

National Health Service surgical list in England.

Methods:

Femtosecond laser-assisted cataract surgery was performed on four (N=4) patients using the Zeimer LDV Z8. The surgical team had never previously used this system to assist with cataract surgery. Patients were randomly selected from a pool of routine cases awaiting surgery. Anterior capsulotomies were performed using the laser with all other stages manually performed by a consultant surgeon. The capsulotomy diameter was measured using surgical calipers and compared to the intended diameter. The timing of cases was recorded and compared with a regular list. Patients were reviewed two weeks post-operatively with visual acuity testing and macular ocular coherence tomography.

Results:

All operations were performed under topical anaesthesia, two patients required intracameral phenylephrine due to small pupil size. Successful capsulotomies were performed in all patients with no complications. Three of the capsulotomies were free floating and one had a small remaining tag and completed easily on removal of the capsulotomy. All capsulotomies were true to the requested size and appeared perfectly circular. There were no intraoperative complications. Three patients had a mean unaided visual acuity of 0.14 (Logmar) at post-operative review. One patient had mild post-operative cystoid macular oedema with a visual acuity of 0.52, improving to 0.18 after topical treatment.

Conclusions:

In this small case series we found the Zeimer Femto LDV Z8 to be a safe tool for performing the anterior capsulotomy in routine cataract surgery. The fluid filled patient interface in the Femto LDV Z8 system reduces distortion of the cornea and therefore improves the accuracy of the laser beam. We found the size and circularity of the anterior capsulotomy to be accurate and reproducible. Larger studies with longer term follow up are needed to further evaluate the results with this technology.

Financial Disclosure:

NONE