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Fluidics of cataract surgery after femtosecond laser capsulotomy and lens fragmentation

Session Details

Session Title: Femtolaser Cataract Surgery

Session Date/Time: Tuesday 08/10/2013 | 14:00-16:15

Paper Time: 14:57

Venue: Auditorium (First Floor)

First Author: : R.Bellucci ITALY

Co Author(s): :    M. Cargnoni              

Abstract Details

Purpose:

Femtosecond laser capsulotomy and lens fragmentation produce a perfectly round capsulotomy and a partially fragmented cataract, with gas bubbles in the anterior chamber and in the posterior lens. These conditions affect surgery fluidics. The most effective fragmentation patterns with the Victus laser and the best phaco settings with the Stellaris machine have been investigated.

Setting:

Specialty Medical Centre, Verona, Italy

Methods:

The characters of the fragmented lenses have been analysed in terms of fluid channels and of fragments volume. Different parameters and strategies have been tested to find the most effective and safe surgical procedure during cataract removal.

Results:

The circular fragmentation lines produced a hard cylinder block with medium-hard cataracts, and was found less effective than the radial pattern. With the radial pattern, the pre-existing fragmentation is better managed with small Phaco tips, favouring 1.8mm and even 1.6mm incisions. With both patters, intralenticular gas bubbles and fragmentation lines slow and divert the fluid stream, impeding hydrodissection and increasing intralenticular pressure.

Conclusions:

The most effective fragmentation pattern with the Victus laser was the radial pattern, according to our experience. Some changes have to be made to adapt phacoemulsification to femtosecond laser cataract surgery. We suggest to use the smallest available tips, and to avoid any risk to increase intralenticular pressure.

Financial Interest:

... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, ... receives consulting fees, retainer, or contract payments from a competing company