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Electron microscopy of laser capsulotomy edge: an inter-platform comparison

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Session Details

Session Title: Cataract Surgery/ Equip/ IOLs

Session Date/Time: Sunday 14/09/2014 | 14:30-16:00

Paper Time: 14:30

Venue: Capital Hall B

First Author: : C.Balachandran AUSTRALIA

Co Author(s): :    K. Meades   Y. Xia           

Abstract Details


To perform a morphological comparsion of capsulotomy edges generated by commercially available femtosecond laser platforms with manual capsulorhexis edges.


Private Clinical Settings


54 capsules were collected using multiple laser platforms and software versions; 10 LenSx 'pre-soft-fit' (Alcon, version 2.16), 10 LenSx 'post-soft-fit' (version 2.20), 4 Victus I (Bausch&Lomb, version 2.5), 10 Victus II (version 2.7SP2) 10 Catalys (Optimedica, version 2.15.13) and 10 manual. Scanning electron microscopy images were analysed by calculating, the coefficient of variation (CoV) of pixilation along the capsular edge and homogeneity using Grey Level Co-Occurrence Matrix Analysis. A qualitative assessment for anomalies such as tags was also made.


Regression analysis demonstrated manual capsulotomy CoV (101.6±0.6%, mean ± stdev) to be smoother than LenSx pre-soft-fit (105.2±1.2%, p <0.001), LenSx post-soft-fit (102.7±1.4%; p = 0.04), Victus I (104.9±0.9%; p<0.001), Catalys (104 .5±1.6%; p<0.001) and Victus II (104.7±1.6%; p<0.001). All lasers (0.19 to 0.23; p<0.001) except for the LenSx post-soft-fit (0.25±0.03, p=0.23) generated less homogenous capsulotomies than the manual technique (0.27±0.04). Tags were seen with LenSx pre- soft-fit (5 of 10), LenSx post-soft-fit (1 of 10), Victus I (1 of 4) and Victus II (3 of 10). Misdirected pulses were seen with the Catalys (4 of 10) and Victus II (3 of 10), which use fluid interfaces.


Laser capsulotomies are approaching the smoothness of manual capsulorhexis. LenSx 'post-soft-fit' demonstrated the least anomalies and the smallest difference to the manual method for the metrics of CoV and Homogeneity.

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