The evaluation of femtosecond laser-assisted anterior capsulotomy in the presence of ophthalmic viscoelastic devices (OVDs)

Session Details

Session Title: Femtolaser-Assisted Cataract Surgery (FLACS)

Session Date/Time: Monday 16/09/2019 | 08:30-10:30

Paper Time: 10:04

Venue: Free Paper Forum: Podium 4

First Author: : H.Mansoor SINGAPORE

Co Author(s): :    Y. Liu   Y. Wong   N. Lwin   X. Seah   J. Mehta                 

Abstract Details

Purpose:

To determine the effectiveness of femtosecond laser-assisted capsulotomy with the Ziemer LDV Z8 in the presence of different ophthalmic viscoelastic devices (OVDs).

Setting:

Singapore Eye Research Institute & Singapore National Eye Center, Singapore.

Methods:

Fresh porcine eyes (n = 96) were randomly allocated to 12 sub-groups. Eyes underwent capsulotomy with the Z8 femtosecond laser (5-mm diameter, cutting depth 0.8 mm, energy 90%, or 150%) either in the presence of an OVD (Viscoat, Provisc, Healon, Healon GV or HPMC) or without. Lens capsules were removed for evaluation of morphological imperfections by scanning electron microscopy (SEM). The capsule circularity and tag-area (mm2) were measured using Image J. The single column universal testing system determined the rupture strength (mN) of the residual capsular bag.

Results:

Increasing energy setting from 90% to 150% in all sub-groups showed significantly better circularity (0.92569 vs 0.96100;p=0.013) and smaller tag-area (0.06 vs 0.02mm2;p=0.016) but an insignificant difference in rupture strength. There was no significant difference in capsule circularity and tag-area amongst the 90% energy sub-groups. However, 90% energy had an increased risk of a capsular tag (p=0.04) and an incomplete laser-cut (p=0.05) compared to 150% energy. Using 150% energy, Healon GV had the worst capsule circularity (p=0.003) and tag-area (p=0.01) compared to other sub-groups. Overall, there was a significant inverse correlation between the circularity and tag-area (p<0.001, r=-0.58).

Conclusions:

It is recommended to use 150% energy with the Z8 femtosecond laser to have a better capsule circularity with a reduced risk of capsular tags and an incomplete laser cut in the presence of an OVD in the anterior chamber. However, even with 150% energy there were significant tags in the presence of Healon GV.

Financial Disclosure:

None