Initial evaluation of a femtosecond laser system in cataract surgery

J Cataract Refract Surg. 2014 Jan;40(1):29-36. doi: 10.1016/j.jcrs.2013.08.045. Epub 2013 Nov 22.

Abstract

Purpose: To report the early experience and complications during cataract surgery with a noncontact femtosecond laser system.

Setting: Hong Kong Sanatorium and Hospital, Hong Kong Special Administrative Region, China.

Design: Retrospective case series.

Methods: All patients had anterior capsulotomy or combined anterior capsulotomy and lens fragmentation using a noncontact femtosecond laser system (Lensar) before phacoemulsification. Chart and video reviews were performed retrospectively to determine the intraoperative complication rate. Risk factors associated with the complications were also analyzed.

Results: One hundred seventy eyes were included. Free-floating capsule buttons were found in 151 eyes (88.8%). No suction break occurred in any case. Radial anterior capsule tears occurred in 9 eyes (5.3%); they did not extend to the equator or posterior capsule. One eye (0.6%) had a posterior capsule tear. No capsular block syndrome developed, and no nuclei were dropped during irrigation/aspiration (I/A). Anterior capsule tags and miosis occurred in 4 eyes (2.4%) and 17 eyes (10.0%), respectively. Different severities of subconjunctival hemorrhages developed in 71 (43.8%) of 162 eyes after the laser procedure. The mean surgical time from the beginning to the end of suction was 6.72 minutes ± 4.57 (SD) (range 2 to 28 minutes).

Conclusions: Cataract surgery with the noncontact femtosecond laser system was safe. No eye lost vision because of complications. Caution should be taken during phacoemulsification and I/A to avoid radial anterior capsule tears and posterior capsule tears.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anterior Capsule of the Lens / surgery
  • Cataract Extraction / methods*
  • Female
  • Humans
  • Intraoperative Complications*
  • Laser Therapy / methods*
  • Lens Implantation, Intraocular
  • Male
  • Middle Aged
  • Refraction, Ocular / physiology
  • Retrospective Studies
  • Risk Factors
  • Visual Acuity / physiology