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Thermal capsulotomy: initial clinical experience, intraoperative performance, safety, and early postoperative outcomes of precision pulse capsulotomy technology
Purpose: To assess the clinical safety and performance of a new thermal capsulotomy device in patients having cataract surgery.
Setting: Launceston Eye Institute, Launceston, Tasmania, Australia.
Design: Prospective case series.
Methods: This single-surgeon consecutive series comprised eyes having capsulotomy with a precision pulse capsulotomy (PPC) device (Zepto). Baseline demographic information and preoperative, intraoperative, and early postoperative outcomes, including complications, intraocular pressure (IOP), flare photometry, corneal and retinal thickness, and specular microscopy were collected and analyzed. Outcomes included PPC performance, intraoperative complications, effective phacoemulsification time, IOP, postoperative inflammation, corneal edema, endothelial cell density, functional evaluation of the corneal endothelium, retinal thickness, cost-effectiveness, and early postoperative visual acuity.
Results: The study evaluated 100 eyes. Complete free-floating capsulotomy was achieved in 70 eyes (72%). Focal attachments were identified in 17 eyes (18%) and broad attachments in 10 eyes (10%). Intended PPC capsulotomy failed in 3 eyes due to operator or device error. Anterior capsule tears occurred in 4 eyes (4%); otherwise, there were no significant safety signals in the early postoperative period. There was no evidence of a learning curve effect; however, use of a dispersive ophthalmic viscosurgical device (OVD) is postulated as influencing capsulotomy completeness.
Conclusions: The PPC device created round, reproducible, appropriately sized capsulotomies in 72% of eyes. The incidence of incomplete capsulotomy and radial tear rate was high and was possibly associated with the use of a dispersive OVD.
History
Publication title
Journal of Cataract and Refractive SurgeryVolume
44Pagination
355-361ISSN
0886-3350Department/School
Tasmanian School of MedicinePublisher
Elsevier Science IncPlace of publication
360 Park Ave South, New York, USA, Ny, 10010-1710Rights statement
Copyright 2018 ASCRS and ESCRSRepository Status
- Restricted