Official ESCRS | European Society of Cataract & Refractive Surgeons


Centration of intraocular lens and morphology of capsulotomy prepared by manual, femtosecond laser, and precision-pulse capsulotomy techniques

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Session Details

Session Title: Cataract Surgery Equipment

Session Date/Time: Monday 16/09/2019 | 08:30-10:30

Paper Time: 09:36

Venue: Free Paper Forum: Podium 3

First Author: : J.Reddy INDIA

Co Author(s): :    S. Devta   K. Vupparaboina   M. Hasnat Ali   P. Vaddavalli                    

Abstract Details


To directly compare capsulotomy produced by precision pulse capsulotomy (PPC), manual (M-CCC) and femtosecond laser assisted capsulotomy (FLAC) in relation to centration, circularity and its effect on visual acuity, refractive outcome and quality of vision.


Prospective evaluation of patients undergoing phacoemulsification procedure and implantation of an acrylic hydrophobic intraocular lens between 1st August 2017 to 31st May 2018 at Cataract and Refractive Services, LV Prasad Eye Institute, Hyderabad, India.


Out of 60 eyes of 52 patients FLAC, PPC and M-CCC were performed in 20 eyes each. At 1week and 5weeks every patient was checked for un-corrected distance visual acuity, corrected distance visual acuity, dilated retro-illumination slit-lamp imaging, aberrations and endothelial cell density(ECD). Since PPC is relatively a new device and would involve a learning curve, hence we compared the results between 1-10 and 11-20 procedures with other groups. The photographs were analyzed using ImageJ and custom-built software based on MATLAB to measure circularity of the capsulotomy, vertical and horizontal diameters, intraocular lens optic edge and pupillary margin detection.


At 1 month the visual, refractive outcomes and ECD were comparable between the 3 groups. The median circularity index was statistically significantly different between M-CCC and PPC (1-10) groups compared to FLAC (p<0.01) but PPC (11-20) was comparable to FLAC. Decentration of IOL center in relation to capsulotomy was seen only between the PPC (1-10) group and FLAC group (P=0.02). The IOL was well centered in relation to the center of the pupil in all the groups(P>0.05). The quality of vision parameters like the HOA, spherical aberration, coma, trefoil, modular transfer function, and Strehl ratio were comparable between the groups.


The results of our study have shown that in spite of a few differences in the morphology of capsulotomy produced by PPC, M-CCC, FLAC a well-centered IOL has been achieved in all the cases. None of the capsular morphology parameters affected the visual, refractive and quality of vision in patients implanted with a monofocal IOL.

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