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Robert Rivera, Steve Linn, Phillip Hoopes, Yari Mitchell; Effects of a Femtosecond Laser Used During a Cataract Procedure on a Corneal Inlay. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1544.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the interaction of two different femtosecond lasers used for Laser-Assisted Cataract Surgery (LACS) on an implanted corneal inlay and targeted ocular tissues
Six KAMRA corneal inlays (AcuFocus, Irvine, CA) were implanted into femtosecond laser created pockets in six porcine eyes. The iFS laser (Abbott Medical Optics, Inc, Santa Ana, CA) and a mask were used to create intrastromal pockets at three different depths: 100, 200 and 300 microns. The eyes were split into two groups; Group 1 was treated with the Catalys Precision Laser System (Abbott Medical Optics, Inc, Sunnyvale, CA), and Group 2 was treated with the LenSx (Alcon, Inc., Fort Worth, TX) femtosecond laser. Each group had 3 eyes, 1 per inlay implantation depth. Lens fragmentation and capsulorhexis were performed on all eyes with each laser. Arcuate incisions were created in one of the eyes in Group 1, over an inlay implanted at 100 microns. After laser phacoemulsification, each eye was assessed under a surgical microscope. The cornea and inlay were inspected and then removed to allow visualization of treatment of the crystalline lens and anterior capsule.
The inlay did not appear to interfere with creation of corneal arcuate incisions. In all cases, the inlay created an optical shadow visible on OCT, behind which laser energy was prevented from reaching target tissues. Anterior capsular treatment appeared unaffected. Crystalline lens fragmentation was observed in all cases. For the eyes treated with the Catalys laser, crystalline lens fragmentation was noted centrally and peripheral to the inlay. No lens fragmentation peripheral to the inlay outer edge was found in LenSx treated eyes. Following all procedures, the inlays appeared to be intact under inspection at the microscope. Further analysis of the inlays using SEM will be performed.
Femtosecond laser treatment with two cataract lasers used in this study does not appear to affect the KAMRA corneal inlay. Corneal arcuate incisions, capsulorhexis and lens fragmentation are possible in the presence of the inlay, but differences in tissue treatment are observed between both lasers.
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