Rx Handheld Femtosecondlaser Assisted (Fsl) Capsulotomy: Initial Clinical Experience, Intraoperative Performance, Safety, And Early Postoperative Outcomes

To assess the clinical safety and performance of a new femtosecond assisted (FSL) capsulotomy device in patients having cataract surgery.

Ophthalmology Clinic, Department of Surgery, Dentistry, Maternity and Infant, University of Verona, Verona, Italy

This consecutive series included eyes having capsulotomy by FSL capsulotomy (Helix, ilasis laser France Bordeaux) 5 minutes before the cataract surgery. All the procedures were suction-free and performed by two cataract surgerons using the blepharostat, after two days of theoretical and pratical training. Baseline data and preoperative, intraoperative, and early postoperative outcomes, including FSL capsulotomy performance, intraoperative complications, postoperative capsulotomy diameter, intraocular pression (IOP) and presence of postoperative inflammation, at 1 and 30 days. Corneal edema, endothelial cell density (ECD) and macular thickness were evaluated at 30 days postoperative.

Twelve cataract patients (7 females and 5 males) were enrolled and underwent the FLS capsulotomy. Effective procedures were performed on 11 out of 12 (91.7%) obtaining a circular FSL incision on the anterior capsule easily removed. of that, focal attachments were identified in 3 eyes (27%) The procedure failed in 1 eye (8.3%) due to operator mistake (instrument misalignment) with a partial corneal FSL incision. All patients underwent cataract surgery without complication mean (± SD) capsulotomy diameter was 5.1 (± 0.09) and 5.1(± 0.10) mm at 1 and 30 days, respectively. No inflammation was recorded. No differences in ECD, IOP and macular thickness were found compared to preoperatively. The corneal incision completely disappeared at 30 days.

The FSL capsulotomy was safe and effective in create round, reproducible, appropriately sized capsulotomies in 91.7%) of eyes. The procedure failed in 1 eye due to instrument misalignment.

The learning curve is remarkably short despite the handheld nature of the device and the absence of suction.