Anterior Capsulotomy Outcomes: Comparisonof 2 Femtosecond Laser Cataract Surgery Platforms

Sunday, April 19, 2015: 1:11 PM
Room 5A (San Diego Convention Center)
Seth M. Pantanelli, MD, MS
Zaina Al-Mohtaseb, MD
Florence Cabot, MD
Daniel Waren, MSPH
William J. Feuer, MS
Sonia H. Yoo, MD
Kendall E. Donaldson, MD, MS

To investigate the frequency of incomplete capsulotomies and magnitude of pupillary miosis associated with using two femtosecond laser cataract surgery platforms prior to phacoemulsification.

This was a prospective comparative case series, with data collected on 295 traditional, 91 Alcon LenSx, and 51 Abbott Medical Optics (AMO) Catalys cases. For each case, the status of the anterior capsulotomy was classified using the following method: Type 1 indicated a complete treatment pattern, Type 2 indicated micro-adhesions, and Type 3 indicated an incomplete treatment pattern. Pupil size was measured pre- and post-docking on both laser platforms.

A Type 2 or Type 3 incomplete capsulotomy was observed in 15.4% of LenSx and 0% of Catalys cases (p < 0.001). The increased incidence of capsular complications was found to be attributed to laser beam misalignment. Once the laser was properly aligned and training cases (first 20) were excluded, the rate of incomplete capsulotomies was 5.9% with the LenSx and 0% with the Catalys (p=0.157). Pupil size decreased by 0.631±1.067 mm in LenSx (p < 0.001) and 0.377±0.637 mm in Catalys (p < 0.001) cases. The greater change in pupil size with LenSx cases was significant (p = 0.027).

The LenSx cases had a higher incidence of incomplete capsulotomies and an increase in pupillary miosis when compared to Catalys cases.