Use Of Selective Laser Capsulotomy For Mature White Cataracts: Initial Experience In Indian Eyes

To report the initial experience of performing capsulotomy in eyes with mature
white cataracts using selective laser capsulotomy (SLC) in Indian eyes.

Private eye clinic, Western India.

This was a prospective, consecutive case series. Inclusion criteria were all adults presenting with mature cataracts whose pupils dilated >6mm and one eye per patient. During surgery, after staining the anterior capsule with CAPSULBlue to provide a chromophore for the laser. Once the laser aiming beam was centred on the coaxial Purkinje image the CAPSULaser device was used to create a 5.3mm capsulotomy.  Phacoemulsification was then carried out. The primary outcomes were the size, centration and continuity of the capsulotomy edge at the end of the surgery at 1 month. Secondary outcomes were the surgical time for the capsulotomy, capsulotomy centration on the IOL at 3 month, endothelial cell count (ECC) loss and adverse effects.

The enrolled patients had a mean age of 66 ± 8 years of which 57% were men. The cataracts were characterized as 20% dry, 6.7% wet and 73.3% intumescent.  At 1 and 3 months the intraoperative size of the capsulotomy was 5.3±0.1mm in all eyes as intended and edges were smooth. None of the eyes experienced any visible capsular tears or runout events; one had a capsular tag. The time for capsulotomy including capsular staining was 3±0.2minutes. The ECC loss for surgery was 8% at 3 months which is consistent with historical manual capsulorhexis data. Vision improved significantly to 0.03 ± 0.06 logMAR. None of the eyes experienced any intraoperative complications or laser-induced adverse effects.

Selective Laser Capsulotomy is  a safe and effective technique providing precise, well centred anterior capsulotomies in mature white cataracts with no incidence of capsulotomy edge tear-out or Argentinian Flag Sign.