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A novel application of Femtosecond laser in pseudophakia: reformation of capsulorhexis by creating a new capsulotomy in cases of anterior capsular contraction syndrome to aid IOL exchange

Poster Details

First Author: D.Kazakos UK

Co Author(s):                  

Abstract Details

Purpose:

To describe a novel use for the Femtosecond Laser (FS-Laser) in helping remodel abnormal capsulorhexis and minimise intraoperative risks in IOL exchange.

Setting:

Optical Express, London, UK

Methods:

A FS-Laser (Catalys, Abbott/Optimedica, USA) was used to create a fresh capsulotomy centred over the phimosed anterior capsulorhexis. After ocular structures were mapped the anterior capsule position was manually adjusted for 0.3mm anteriorly of its actual position and the posterior capsule was at over 1 mm posterior to this at the edge of a 4.8-5.0 mm capsulotomy. Then the desired centration was selected and the anterior capsulotomy was created. A small amount of gas was formed in the interface of the anterior capsule and the lens substance. Laser settings: Incision depth 600um, spot spacing 5umx10um x 4.0uJ pulse energy.

Results:

Two patients that had been consented appropriately were scheduled for IOL exchange due to intolerable glare and poor QoV. The first patient, a 12-month postop LentisMPlusX-IOL had lens decentration with tilting whereas the second a 4-month postop Tecnis Symfony-ZXR00-IOL had anterior capsular-contraction syndrome. During the IOL exchanges the excess capsular fragments were mobilised and easily separated with microforceps revealing a complete, round capsulotomy thus allowing for an uneventful IOL exchange. The lenses were slightly scored from the laser to less than a 5th of their thickness. The postoperative care was routine and the recovery uneventful.

Conclusions:

This innovative use of FS laser could facilitate an atraumatic explantation of IOLs in the presence of a phimotic, small, irregular and opacified anterior capsulorhexis. More research is needed to prove the efficacy of the procedure and establishing the appropriate energy levels required for the desired effect. FINANCIAL DISCLOUSRE: NONE

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