Comparison of elasticity and fracture strength of manual, femtosecond laser, and selective laser capsulotomies

Session Details

Session Title: Capsular Management

Session Date/Time: Sunday 23/09/2018 | 16:30-18:00

Paper Time: 16:42

Venue: Room A4

First Author: : S.Daya UK

Co Author(s): :    R. Packard   S. Chee                 

Abstract Details

Purpose:

To compare the anterior capsulotomy edge fracture strength created by manual continuous curvilinear capsulorhexis (CCC), femtosecond laser assisted cataract surgery (FLACS), and Selective Laser Capsulotomy (SLC).

Setting:

Singapore National Eye Centre

Methods:

Capsulotomies were performed in 60 cadaver eyes of 30 donors using CCC, Victus Femtosecond Laser, (Bausch & Lomb, Rochester, NY) or CAPSULaser, (Excel-Lens, Los Gatos, CA). Three study arms each involved 10 pairs of eyes. First arm: one eye SLC and fellow eye CCC. Second arm: 1 eye FLACS and fellow eye CCC. Third arm: SLC and fellow eye FLACS. Shoe-tree method used to apply load to capsulotomy edge, and Instron tensile stress instrument measured extension and load applied to capsule fracture. Relative fracture strengths of CCC, FLACS and SLC were determined. Scanning electron microscopy (SEM) of capsule edges reviewed.

Results:

The pairwise study demonstrated that the SLC fracture strength is superior to that of CCC by a factor of 1.5-fold with SLC 280 + 30 mN vs. CCC with 180 + 35 mN. Furthermore, CCC fracture strength was superior to that of FLACS by a factor of 1.4-fold with CCC 190 + 35 mN vs. FLACS 140 + 20 mN (P < 0.001 as determined by statistical analysis utilizing the Wilcoxon matched-pairs signed-ranks test and in accordance with the CONSORT guidelines). The SLC capsule edge on SEM demonstrated a rolled over edge anteriorly and alteration of collagen.

Conclusions:

The strength of the capsulotomy edge for SLC was significantly stronger than that of CCC which in turn was greater than FLACS. The relative strengths can be explained by review of SEM of each type of capsulotomy.

Financial Disclosure:

... has significant investment interest in a company producing, developing or supplying product or procedure presented, ... research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, ... receives consulting fees, retainer, or contract payments from a competing company, ... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented