michael c. knorz 1, m.d., zoltan nagy 2, m.d. · marques ff, marques dm, osher rh, osher jm. fate...

Michael C. Knorz1, M.D., Zoltan Nagy2, M.D.

1Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany2Semmelweis University, Budapest, Hungary

Introduction

Ultrasound use in phaco surgery has been associated with post-operative complications such as corneal burn, corneal edema and endothelial cell loss (*,**,)

An intact capsulorhexis is the most important step t o prevent capsule tears and vitreous loss

*Pereira et al. JCRS 2006 Oct;32(10):1661-6

**Park et al. Ophthalmic Surg Lasers Imaging. 2010 Mar-Apr;41(2):236-41

Incidence of Capsule Tears

Marques FF, Marques DM, Osher RH, Osher JM.Fate of anterior capsule tears during cataractsurgery.J Cataract Refract Surg 2006;32:1638-42

2,646 eyesAnterior tear of capsulorhexis in 0.8 %• 40% of tears extended into the posterior capsule,

20% required vitrectomy

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Incidence of Capsule Tears - Residents

Unal M, Yücel I, Sarici A, Artunay O, Devrano ğlu K, Akar Y, Altin M.Phacoemulsification with topical anesthesia: Resident experience.J Cataract Refract Surg. 2006 Aug;32:1361 -5J Cataract Refract Surg. 2006 Aug;32:1361 -5

Anterior tear of capsulorhexis in 5.3%Irregular anterior capsulorhexis in 9.3%Posterior capsule tears with vitreous loss in 6.6%

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Purpose

To evaluate the use of a novel femto-second laser in cataract surgery for

liquefaction of the lens,liquefaction of the lens,capsulorhexis, corneal incisions

LenSx Femtosecond Laser

Setting

• Procedures performed by Michael Knorz at Semmelweis University, Budapest, Hungary

• Thanks to my host, Zoltan Nagy

MethodologyPatients for cataract surgery underwent photolysis of the lens, capsulorhexis and corneal incision with a femtosecond laser (LenSx Lasers, Aliso Viejo, CA)

Laser surgery used integrated real-time OCT to position laser applicationposition laser application

Simple I/A was used to extract the liquefied lens material

Laser Cataract Surgery

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Nucleus Liquefaction

Results

FS laser was highly effective in liquefying the nucleus, I/A was required for lens removal only

Average laser treatment time = 35 secs

Capsulorhexis was highly reproducible

Conclusions

Femtosecond laser application in

liquefaction, capsulorhexis and corneal

incisions was safe and effective

The all-laser cataract surgery will increase

safety and efficiency of cataract removal

Laser optimization will further improve the

effectiveness in liquefying hard nuclei

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