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    Laser capsulotomy studies affirm low rate of anterior capsule tears

    Refinement of laser settings, surgical technique over time ‘game changers’ for free-floating capsulotomies

    Sydney—Significant evidence in the literature shows that use of a femtosecond laser consistently creates a capsulotomy with precise geometry, circularity, and sizing. 

    Now, data from large studies also establish that the laser procedure is associated with a very low rate of anterior capsule tears, said Tim Roberts, MD.

    “These are important points because the quality of the anterior capsulotomy is crucial to the safety and refractive outcome of cataract surgery,” said Dr. Roberts, consultant ophthalmic surgeon and clinical senior lecturer, University of Sydney and medical director, Vision Eye Institute Australia.

    Dr. Roberts and colleagues at the Vision Eye Institute, Chatswood, reported their experience using a femtosecond laser platform (LenSx, Alcon Laboratories). In their prospective, consecutive series of 3,842 eyes, 7 eyes (0.18%) were identified as having a break in the anterior capsule rim.

    However, further analyses showed the rate dropped significantly to 0.08% when the new soft contact lens patient interface (SoftFit) replaced the original rigid curved interface (0.08%, 2/3108 eyes versus 0.68%, 5/734 eyes, p = 0.004).

    Dr. Roberts emphasized that the eyes in his group’s series was a consecutive cohort and included complex cases that may be at increased risk for anterior capsule tear—e.g., eyes with floppy iris syndrome, white cataract, pseudoexfoliation, and traumatic zonulopathy.

    Putting it into perspective

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