Intraoperative and postoperative complications of high-frequency capsulotomy and continuous curvilinear capsulorhexis

To compare the intraoperative complications and postoperative blood-aqueous barrier (BAB) disturbance after high-frequency capsulotomy and continuous curvilinear capsulorhexis (CCC).

Vienna General Hospital, Vienna, Austria.

This prospective, randomized clinical study evaluated 53 eyes with senile cataract. Patients were divided into two groups: high-frequency capsulotomy (n = 27) or CCC (n = 26). The surgical procedure and postoperative therapy were standardized for both groups. The intraoperative course was documented, and postoperative complications were examined by biomicroscopy 3 months postoperatively. Without the pupil dilated, BAB disturbance was evaluated with a laser flare-cell meter at 1, 3, 7, and 14 days postoperatively. The findings were analyzed statistically.

Intraoperatively, the high-frequency capsulotomy group had a significantly higher rate of radial tears in the anterior lens capsule. Postoperatively, this resulted in a higher incidence of postoperative false positioning of the intraocular lens. At no time were the flare-cell meter results between groups statistically significant.

High-frequency capsulotomy resulted in no more trauma than CCC. It can be a good alternative to conventional techniques, particularly in eyes with no red reflex. However, the technique is associated with less mechanical stability.