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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