Minimizing complications in intumescent white cataracts: a comparison between manual and femtosecond laser-assisted capsulotomy

Session Details

Session Title: Femtocataract I

Session Date/Time: Sunday 14/09/2014 | 08:00-10:00

Paper Time: 09:36

Venue: Boulevard A

First Author: : F.Hengerer GERMANY

Co Author(s): :    H. Dick   T. Kohnen   I. Conrad-Hengerer        

Abstract Details

Purpose:

To evaluate intraoperative complications during capsulorrhexis and phacoemulsification in intumescent white cataracts using two different viscosurgical techniques for the capsulorrhexis or performing a femtosecond laser-assisted capsulotomy.

Setting:

Ruhr University Eye Clinic, Bochum, Germany

Methods:

In the two manual groups after capsular staining with trypan blue in the first group (21 patients) a medium viscous ocular viscosurgical device (OVD) was used whereas in the second group (20 cases) both medium and high viscous OVD have been used to create a central indentation of the anterior lens capsule before a circular curvilinear capsulorrhexis (CCC) had been performed. In the third group (21 patients) the capsulorrhexis was performed with a femtosecond laser system. The capsule was stained intraoperatively with trypan blue and pulled out using a microsurgical forceps. Main outcome measures were the size of the CCC and analysis of complications during surgery.

Results:

In the first group deviation from target CCC diameter appeared in 12 cases compared to 6 cases in the second group. In the first group in two cases a capsular tear appeared and one case had to be converted to ECCE with anterior vitrectomy. In the second group there were no capsular tears. In the femtosecond laser-assisted group one radial anterior tear occurred and in 7 eyes an adherent tongue-like capsular adhesion; the mean deviation from the target diameter of the extracted capsule-discs valued 62 ± 41 µm. An IOL could be implanted into the capsular bag in all cases.

Conclusions:

Combination of two different OVDs with high viscous OVD placed centrally lead to a safe indentation of the anterior lens capsule and reduced intraoperative complications. Femtosecond laser-assisted capsulotomy in intumescent white cataracts was superior according to size, shape and safety.

Financial Interest:

One or more of the authors... is employed by a forNONEprofit company with an interest in the subject of the presentation