Anterior capsulotomy with a pulsed-electron avalanche knife

Area of Science:

• Ophthalmic surgery
• Surgical instrumentation
• Cataract surgery technology

Background:

• Continuous curvilinear capsulotomy (CCC) is a critical step in cataract surgery.
• Existing methods like mechanical capsulorhexis can have limitations.
• Novel technologies are sought to enhance CCC precision and safety.

Purpose of the Study:

• To evaluate a novel pulsed-electron avalanche knife for CCC creation.
• To compare the capsulotomy quality produced by the new knife versus mechanical capsulorhexis.

Main Methods:

• CCCs were created in bovine eyes and rabbit eyes in vivo using the pulsed-electron avalanche knife.
• Surgical parameters (burst repetition rate, voltage, burst duration) were adjusted to optimize cutting velocity and visualization.
• Histology and scanning electron microscopy (SEM) were used to assess tissue cutting quality.

Main Results:

• The pulsed-electron avalanche knife achieved adjustable cutting velocities up to 2.0 mm/s.
• Optimal settings produced sharp-edged capsular cuts without radial nicks or tears.
• Minimized gas-bubble formation enhanced surgical visualization.

Conclusions:

• The pulsed-electron avalanche knife provides a tactile feedback similar to a cystotome.
• It creates histologically smooth capsular cuts, suggesting improved precision and reproducibility.
• This technology may enhance CCC sizing and centration, particularly in complex surgical scenarios.