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Morphological changes in the edge structures following femtosecond laser capsulotomy with varied patient interfaces
Thomas Kohnen1, Oliver K Klaproth, Marko Ostovic
1Department of Ophthalmology, Goethe-University Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany, kohnen@em.uni-frankfurt.de.
Background:
To ascertain the morphological changes in the edge structure of femtosecond laser-derived capsulotomy specimens using varying patient interfaces and different laser pulse energies.
Methods:
In this experimental clinical study femtosecond laser-assisted capsulotomies were performed in 30 eyes using the LenSx femtosecond laser (LenSx, Alcon, Fort Worth, TX, USA). Surgery was performed using either a rigid curved contact interface (group 1, 15 eyes) or a curved interface with a soft contact lens between cornea and interface (group 2, 15 eyes). The laser pulse-energy was set to 15 μJ in group 1 and to 5 μJ in group 2. After the removal of the anterior capsule, half of the specimens from each group underwent either further staining for light microscopy (LM) or scanning electron microscopy (SEM). Cell configuration, capsule shape, and edge abnormalities were analysed on a morphological basis.
Results:
LM showed continuous anterior capsular incisions with a prominent demarcation line along the cutting edge, as well as tags and bridges, which were more pronounced in group 1. SEM revealed further smaller microgrooves and sawtooth patterns in both groups, and a more regular demarcation line configuration in group 2.
Conclusion:
A soft contact lens interface with a subsequent laser pulse energy of 5 μJ resulted in fewer tags and bridges, smoother edges, and a more regular and thinner demarcation line on specimens edges of femtosecond laser-performed capsulotomies compared to a rigid curved 15 μJ interface application.
