Safety And Efficacy Of Selective Laser–Assisted Capsulotomy In White Intumescent Cataracts: An International Multicentre Study

To evaluate the efficacy and safety of a selective laser device (CAPSULaser, EXCEL- LENS, CA, USA) to create centred, sized and circular anterior capsulotomies in eyes with white intumescent cataracts

International, multicentre, study across five clinical sites in the United Kingdom, Bulgaria, India and Saudi Arabia

Prospective, multicentre interventional cohort study, A total of 93 eyes of 91 subjects with white intumescent cataracts were recruited after anterior segment OCT (AS-OCT) established the presence of intralenticular fluid pockets indicative of raised intralenticular pressure. In all cases, prior to phacoemulsification, selective laser capsulotomy (SLC) was performed by staining the anterior capsule with a customised 0.4 % trypan blue solution. Capsulotomies were created with a diameter of 5.5 mm. Subjects were followed up at one day, one week, one and three months postoperatively.

In all cases, the capsulotomy was successfully created as planned. No intraoperative complications were observed. At 3 months postoperatively the mean capsulotomy diameter measured 5.3 mm (range: 5.2 to 5.5 mm). No cases of capsular phimosis were observed during the three months follow-up period. In all cases, visual acuity improved from preoperative light perception to mean postoperative uncorrected distance visual acuity (UDVA) of 0.28 LogMAR (range: 0.0 to 1.0).

The use of SLC in this series of eyes with intumescent cataracts achieved consistently sized, continuous and well-centred capsular openings. There were no complications such as the Argentine flag sign or anterior capsular tears. These results highlight the precision and safety of using selective laser capsulotomy for creating anterior capsulotomies in white intumescent cataracts.