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Femtosecond capsulotomy optimizes monofocal IOL position and power
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CHICAGO – Use of a femtosecond laser boosted the accuracy of capsulotomy sizing and centration in a study that looked at laser-made capsulotomies and manual capsulorrhexes, a speaker said here.
Furthermore, results of the 50-patient study showed femtosecond laser enhanced the refractive predictability of monofocal IOLs, Kerry D. Solomon, MD, reported at the American Society of Cataract and Refractive Surgery annual meeting.
“We’re beginning to demonstrate better accuracy,” Dr. Solomon said.
Patients underwent a 5 mm capsulotomy with the LenSx femtosecond laser in one eye and a manual capsulorrhexis of the same size in the fellow eye. Patients were implanted with a SN60WF monofocal IOL (Alcon). Dr. Solomon and colleagues compared effective lens position, refractive predictability and standard visual outcomes 1 month postoperatively.
Study results showed statistically significant improvement in the precision of IOL positioning with the laser capsulotomy. Refraction was within 0.25 D of the target value in 25% more eyes in the laser group than in the manual surgery group.
Results of a patient survey showed that 84% of patients said they would elect to undergo another LenSx procedure.
Dr. Solomon and colleagues have launched a contralateral, randomized study on femtosecond capsulotomy and refractive predictability.
- Disclosure: Dr. Solomon has financial relationships with Abbott Medical Optics, Advanced Vision Science, Aquesys, Alcon, Allergan, Bausch + Lomb, Glaukos and QLT Corporation.
Perspective
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Michael A. Lawless, MD
This contralateral eye study comparing femtosecond laser capsulotomy in one eye vs. manual capsulotomy in the other, and its effect on the accuracy of refraction 1 month postoperatively, is preliminary evidence that laser cataract surgery will allow for more accurate outcomes. There was a statistical difference, with the laser group being 25% more likely to be within 0.5 D of target refraction. Will this improved accuracy justify the shift to laser cataract surgery? For some patients and surgeons, the possibility of a slightly more accurate outcome would be enough. When combined with improved safety, it may be sufficient to shift patients and the profession in the direction of laser cataract surgery. Most, however, will want more data from a variety of sources and longer follow-up to see that the improved outcomes are sustained.
Studies like this are encouraging ophthalmologists to look at their current manual results as well to see how they compare with best practice. Raising the accuracy bar for cataract surgery, whether it be by improved manual techniques or by the introduction of femtosecond laser, is all good news, in my view.
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