Innovative Application Of Capsulaser For Pediatric Cataract Surgery: A Retrospective Cohort Study On Safety And Precision

This retrospective cohort study aims to evaluate the use of capsulaser technology in pediatric cataract surgeries performed at KKESH over 6 months period.The primary objective of this study is to assess the safety and efficacy of capsulaser-assisted capsulotomy in pediatric cataract surgery.. Secondary objectives are evaluating the precision and circularity of capsulotomies created by capsulaser, to evaluate the incidence of intraoperative complications, particularly anterior capsule tears, and To evaluate Changes in capsulotomy size over time with Incidence and severity of anterior capsular phimosis.

Our study evaluated the safety and efficacy of CAPSULaser for capsulotomy in 21 pediatric cataract patients. Given the high elasticity of pediatric lens capsules, achieving precise and stable capsulotomies remains a significant surgical challenge. CAPSULaser, which is currently utilized off-label in pediatric patients, was assessed for its potential to enhance this critical procedural step.

This retrospective cohort study was conducted at King Khaled Eye Specialist Hospital (KKESH) between August 2024 and February 2025. The research adhered to the principles of the Declaration of Helsinki and received ethical approval from the institutional review board (RP-24125). The study included pediatric patients (aged 0–18 years) diagnosed with congenital or developmental cataracts who underwent Capsulaser-assisted cataract surgery. A minimum follow-up period of one month was required for inclusion. Patients with traumatic cataracts or associated ocular comorbidities, such as microphthalmia or persistent fetal vasculature (PFV), were excluded from the study.

Demographic and clinical variables were analyzed. The sole observed complication was corneal burn spots in 5 patients (23.8%), which resolved within weeks in 4 cases; 1 patient retained a faint, peripheral scar outside the visual axis. All burn cases occurred during the initial phase of the learning curve and were associated with improper laser focusing. The remaining 16 patients (76.2%) underwent uneventful surgeries with well-centered, stable capsulotomies.

While CAPSULaser demonstrates potential advantages, further comparative studies are necessary to establish its long-term safety and efficacy. These findings underscore the significance of technological innovations in pediatric cataract surgery, particularly for enhancing precision and consistency in capsulotomy. Furthermore, we will present video footage illustrating the surgical technique, thereby providing insights into procedural refinements and optimal practices.