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Updated: Aug 9, 2025

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Selective laser capsulotomy complications: Management and prevention.

Vito Romano1, Davide Romano1, Antonio Iaria1

  • 1Eye Clinic, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.

European Journal of Ophthalmology
|February 17, 2023
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Summary

Preventing incomplete laser capsulotomy requires proper anterior lens capsule staining and laser beam focusing. Using vitrectomy scissors is the safest method for managing uncut tags during cataract surgery.

Keywords:
Cataractcapsulorhexiscapsulotomycomplicationlaser

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Area of Science:

  • Ophthalmology
  • Surgical Technology

Background:

  • Selective laser capsulotomy is a precise method for anterior lens capsulotomy.
  • Incomplete cuts can lead to uncut tags, complicating cataract surgery.

Purpose of the Study:

  • To detail methods for managing and preventing incomplete laser anterior capsulotomy.
  • To evaluate techniques for addressing uncut tags after laser capsulotomy.

Main Methods:

  • Described three techniques: forceps peeling, cystotomy needle manipulation, and vitrectomy scissors use.
  • Compared the safety and efficacy of each method for tag removal.

Main Results:

  • Vitrectomy scissors (23-G) use resulted in no complications.
  • Forceps peeling risked zonular dialysis; needle tip use caused irregular capsulotomy rims and micro tears.

Conclusions:

  • Incomplete laser cuts create tags adhering the disc to the capsule.
  • Proper staining and focusing prevent incomplete cuts; scissors are recommended for managing tags.