Fritz H. Hengerer,
Goethe-University Frankfurt, Germany.
Title: Minimizing complications in intumescent white cataracts: a comparison between manual and femtosecond laser-assisted capsulotomy
Biography
Biography: Fritz H. Hengerer,
Abstract
Purpose: To evaluate intraoperative complications during capsulorrhexis and phacoemulsification in intumescent white cataracts using two different viscosurgical techniques for the capsulorrhexis or performing a femtosecond laser-assisted capsulotomy.
Methods: In the two manual groups after capsular staining with trypan blue in the first group (21 patients) a medium viscous OVD was used whereas in the second group (20 cases) both medium and high viscous OVD have been used to create a central indentation of the anterior lens capsule before a CCC had been performed. In the third group (24 patients) the capsulorrhexis was performed with a femtosecond lasersystem. The capsule was stained intraoperatively with trypan blue and pulled out using a microsurgical forceps. Main outcome measures were the size of the CCC and analysis of complications during surgery.
Results: In the first group deviation from target CCC diameter appeared in 12 cases compared to 6 cases in the second group. In the first group in two cases a capsular tear appeared and one case had to be converted to ECCE with anterior vitrectomy. In the second group there were no capsular tears. In the femtosecond laser-assisted group one radial anterior tear occurred and in 7 eyes an adherent tongue-like capsular adhesion; the mean deviation from the target diameter of the extracted capsule-discs valued 62 ± 41 µm. An IOL could be implanted into the capsular bag in all cases.
Conclusions: Combination of two different OVDs with high viscous OVD placed centrally lead to a safe indentation of the anterior lens capsule and reduced intraoperative complications. Femtosecond laser-assisted capsulotomy in intumescent white cataracts was superior according to size, shape and safety.