Experience in Capsulotomy With Femtosecond Laser in Intumescent Cataract at the Asociacion Para Evitar La Ceguera in Mexico
Purpose
To describe the effectiveness and safety of capsulotomy performed with femtosecond cataract laser in intumescent cataracts and to determine the frequency of complications associated with femtosecond laser capsulotomy in comparison with the manual capsulorhexis in intumescent cataracts.
Methods
Prospective, longitudinal, and interventional study of 100 eyes with intumescent cataract, which underwent cataract surgery by phacoemulsification. The eyes were divided into two groups: once with manual capsulorhexis and the other with femtosecond cataract laser capsulotomy. In all of them we stained the capsule with trypan blue and remove it with Utrata forceps. Cataract extraction was performed with the technique of choice for each surgeon. We described if the capsulorhexis and capsulotomy were complete, if we have free cap, or if there were adhesions, the meridians we have to complete manually, if there were capsular tears, and intraoperative complications.
Results
A total of 100 eyes in the study, 60.3% presented intumescent cataract in the right eye, 29.7% in the left eye, and 10% bilateral. The average age was 59 years. Preoperative visual acuity was 20/800 or worse in 100% of cases. A complete capsulotomy in 73% was obtained. Of the incomplete once, 50% were attached in one meridian, 40% in 2, and 10% in more than 3. Postoperative visual acuity was 20/30 or better in 63%, 20/40 in 22.2%, 20/80 in 7.4%, and 7.4% over 20/400. The most frequent complications were capsular tears (14.8%) and posterior capsule rupture(7.4%).
Conclusion
The femtosecond laser assisted capsulotomy in intumescent cataract proved to be 100% secure despite the small adhesions that may exist. It is also a reproducible and predictable procedure. Finally, we believe that the femtosecond laser offers a technological advantage and reduces the risk of complications associated with manual capsulorhexis.