Abstract
Background
To ascertain the morphological changes in the edge structure of femtosecond laser-derived capsulotomy specimens using varying patient interfaces and different laser pulse energies.
Methods
In this experimental clinical study femtosecond laser-assisted capsulotomies were performed in 30 eyes using the LenSx femtosecond laser (LenSx, Alcon, Fort Worth, TX, USA). Surgery was performed using either a rigid curved contact interface (group 1, 15 eyes) or a curved interface with a soft contact lens between cornea and interface (group 2, 15 eyes). The laser pulse-energy was set to 15 μJ in group 1 and to 5 μJ in group 2. After the removal of the anterior capsule, half of the specimens from each group underwent either further staining for light microscopy (LM) or scanning electron microscopy (SEM). Cell configuration, capsule shape, and edge abnormalities were analysed on a morphological basis.
Results
LM showed continuous anterior capsular incisions with a prominent demarcation line along the cutting edge, as well as tags and bridges, which were more pronounced in group 1. SEM revealed further smaller microgrooves and sawtooth patterns in both groups, and a more regular demarcation line configuration in group 2.
Conclusion
A soft contact lens interface with a subsequent laser pulse energy of 5 μJ resulted in fewer tags and bridges, smoother edges, and a more regular and thinner demarcation line on specimens edges of femtosecond laser-performed capsulotomies compared to a rigid curved 15 μJ interface application.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Auffarth GU, Reddy KP, Ritter R, Holzer MP, Rabsilber TM (2013) Comparison of the maximum applicable stretch force after femtosecond laser-assisted and manual anterior capsulotomy. J Cataract Refract Surg 39:105–109
Bali SJ, Hodge C, Lawless M, Roberts TV, Sutton G (2012) Early experience with the femtosecond laser for cataract surgery. Ophthalmology 119:891–899
Friedman NJ, Palanker DV, Schuele G, Andersen D, Marcellino G, Seibel BS, Batlle J, Feliz R, Talamo JH, Blumenkranz MS, Culbertson WW (2011) Femtosecond laser capsulotomy. J Cataract Refract Surg 37:1189–1198
Kohnen T (2013) Interface for femtosecond laser-assisted lens surgery. J Cataract Refract Surg 39:491–492
Kranitz K, Mihaltz K, Sandor GL, Takacs A, Knorz MC, Nagy ZZ (2012) Intraocular lens tilt and decentration measured by Scheimpflug camera following manual or femtosecond laser-created continuous circular capsulotomy. J Refract Surg 28:259–263
Lawless M, Bali SJ, Hodge C, Roberts TV, Chan C, Sutton G (2012) Outcomes of femtosecond laser cataract surgery with a diffractive multifocal intraocular lens. J Refract Surg 28:859–864
Nagy ZZ (2012) Advanced technology IOLs in cataract surgery: pearls for successful femtosecond cataract surgery. Int Ophthalmol Clin 52:103–114
Ostovic M, Klaproth OK, Hengerer FH, Mayer WJ, Kohnen T (2013) Light microscopy and scanning electron microscopy analysis of rigid curved interface femtosecond laser-assisted and manual anterior capsulotomy. J Cataract Refract Surg 39:1587–1592
Palanker DV, Blumenkranz MS, Andersen D, Wiltberger M, Marcellino G, Gooding P, Angeley D, Schuele G, Woodley B, Simoneau M, Friedman NJ, Seibel B, Batlle J, Feliz R, Talamo J, Culbertson W (2010) Femtosecond laser-assisted cataract surgery with integrated optical coherence tomography. Sci Transl Med 2:58ra85
Roberts TV, Lawless M, Bali SJ, Hodge C, Sutton G (2013) Surgical outcomes and safety of femtosecond laser cataract surgery: a prospective study of 1500 consecutive cases. Ophthalmology 120:227–233
Szigeti A, Kranitz K, Takacs AI, Mihaltz K, Knorz MC, Nagy ZZ (2012) Comparison of long-term visual outcome and IOL position with a single-optic accommodating IOL after 5.5- or 6.0-mm femtosecond laser capsulotomy. J Refract Surg 28:609–613
Talamo JH, Gooding P, Angeley D, Culbertson WW, Schuele G, Andersen D, Marcellino G, Essock-Burns E, Batlle J, Feliz R, Friedman NJ, Palanker D (2013) Optical patient interface in femtosecond laser-assisted cataract surgery: contact corneal applanation versus liquid immersion. J Cataract Refract Surg 39:501–510
Trivedi RH, Wilson ME Jr, Bartholomew LR (2006) Extensibility and scanning electron microscopy evaluation of 5 pediatric anterior capsulotomy techniques in a porcine model. J Cataract Refract Surg 32:1206–1213
Financial disclosure
Oliver Klaproth received travel reimbursements and/or lecture fees from the following companies: Alcon, Rayner and Oculus.
Thomas Kohnen received travel reimbursements, grant support and/or lecture fees from the following companies: Alcon, Abbott, Bausch & Lomb, Carl Zeiss Meditec, Neoptics, Rayner, Schwind. He is consultant to Alcon, Carl Zeiss Meditec, Diomed, Rayner, and Schwind.
Conflict of interest
All authors certify that there exists no actual or potential conflict of interest in relation to this article.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kohnen, T., Klaproth, O.K., Ostovic, M. et al. Morphological changes in the edge structures following femtosecond laser capsulotomy with varied patient interfaces and different energy settings. Graefes Arch Clin Exp Ophthalmol 252, 293–298 (2014). https://doi.org/10.1007/s00417-013-2547-5
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00417-013-2547-5