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Rushi K Talati, Ritika Dalal, Dilraj Singh Grewal, Surendra Basti; Prospective randomization evaluation of intraocular lens centration with scanned capsule versus limbus-based capsulotomy for femtosecond laser assisted cataract surgery. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1301.
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© ARVO (1962-2015); The Authors (2016-present)
The introduction of femtosecond lasers to cataract surgery represents a potential paradigm shift in cataract technology. While studies have shown that a capsulotomy created by the femtosecond laser can improve IOL centration compared to manual continuous curvilinear capsulorhexis, little has been published about anatomic outcomes with different methods of laser capsulotomy centration. This prospective, randomized study was performed to determine the influence of a scanned capsule versus limbus-based laser capsulotomy centration method on the centration and stability of the capsulotomy and intraocular lens (IOL).
21 eyes from 14 patients undergoing femtosecond laser-assisted cataract surgery (CATALYS® Precision Laser System; Abbott Medical Optics, Illinois, USA) were randomized to either the scanned capsule (n=10) or limbus-based (n=11) method of centration. Digital retroillumination photographs were obtained intraoperatively and 1 month postoperatively. Circularity index, vector decentration, total decentration, and rim-to-optic overlap were determined using Photoshop CS6 (Adobe Systems Inc). A benchmark value of 1.0 was used for circularity and overlap to indicate a theoretically perfect circle and perfect capsular rim-to-optic overlap, respectively.
Intraoperatively, the mean circularity index between scanned capsule (0.891 ± 0.008) and limbus-based (0.893 ± 0.004) capsulotomies was not significantly different (p=0.38). Vector decentration from the pupillary center was 0.323 ± 0.120 mm for scanned capsule compared to 0.263 ± 0.131 mm for limbus-based capsulotomies (p=0.28). Vector decentration did not exceed 0.4 mm in either group. 10/10 scanned capsule and 10/11 limbus-based capsulotomies had complete 360° rim-to-optic overlap. However, limbus-based capsulotomies were closer to an overlap value of 1.0 than scanned capsule capsulotomies (p=0.05). At one month, there were no significant intergroup differences in capsulotomy circularity, decentration, or overlap.
Limbus-based laser capsulotomy achieves better centration and overlap intraoperatively. However, intergroup differences decrease one month following surgery, suggesting a shift in both capsulotomy and IOL positions. The study is ongoing to evaluate more patients (n=50) and follow-up through 1 year.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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