Anterior Capsule Tear in Femtosecond Cataract Surgery

Anterior Capsule Tear in Femtosecond Cataract Surgery © 2019 American Academy of Ophthalmology

Anterior Capsule Tear in Femtosecond Cataract Surgery



With the emergence of the femtosecond laser cataracts surgery as an available option to patients, there was a paradigm shift there were a few questions regarding the efficacy of the initial surgical outcome.

One topic of interest for surgeons and optometrists, alike, is the integrity of the anterior capsule following femtosecond laser cataracts surgery. We will discuss here a bit about how the eye works and what this could mean for the future visual potential of patients who have undergone the femtosecond laser treatment prior to phacoemulsification.


The Inevitable Learning Curve for the Femtosecond laser

As with any new equipment, there was a learning curve when the femtosecond laser made its debut into private practice. There are now a handful of companies that have developed a femtosecond laser to assist in the first few steps of cataract surgery.



The most prominent, however, is the lensx femtosecond laser, produced by Alcon, the 500 pound gorilla in the ophthalmic industry. Due to the perforation technique, along with the aberrant pulses of the lensx femtosecond laser, the integrity of the anterior capsule was compromised in many cataract cases performed when the femtosecond laser first came into use.

Another causation of the tears created in the anterior capsule, following femtosecond laser-assisted cataract surgery, was the possible movement of the eye during the case.

Now that the femtosecond laser has been in use for several years, incidences of the anterior capsule tearing has decreased, however it still does happen. This can cause refractive error following cataract surgery, due to the anterior capsules  affect on the effective lens position (ELP) of the implanted Intraocular Lens.

The cause and effect of the femtosecond laser-assisted anterior capsulotomy leaves room for further investigation into the question of does the use of the femtosecond laser actually degrade the quality of the anterior capsule due to the use of laser, rather than the traditional continuous curvilinear anterior capsulorhexis.



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