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First Author: J.Gayton USA
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To evaluate the use of the femtosecond laser for creation of the anterior capsulotomy opening, lens fragmentation, relaxing incisions and clear corneal incisions prior to standard cataract surgery.
Amsterdam RAI, Europaplein, NL 1078 GZ, The Netherlands
Patients undergoing standard cataract surgery were treated with a femtosecond laser to create the anterior capsule opening, fragment the lens, create clear corneal incisions, and relaxing incisions if necessary. Following femtosecond laser treatment, the patients underwent standard cataract surgery.
Our initial results included one patient that had superior and inferior anterior capsulotomy tears that developed when the anterior chamber collapsed due to opening of the primary incision first. Four patients developed capsular block resulting in vitrectomies and sulcus fixated lenses. Several of the corneal incisions were unable to be opened. On occasion there were incomplete capsulorrhexis that resulted in no complications. All of the patients achieved post-op best-corrected visual acuity of 20/25 or better.
Femtosecond laser technology use in cataract surgery has several differences that can cause complications: 1) the anterior capsule is open prior to opening the eye therefore an anterior chamber collapse can result in anterior capsule tears, 2) large gas bubbles posterior to the lens can contribute to capsular block syndrome, 3) an incomplete capsulorrhexis can result in radial extension, and 4) laser energy in the nucleus can be directed too anterior, too peripheral, and too posterior. Adjustments to the surgical technique can help manage these complications appropriately.