Gavriș Monica, Mateescu Radu, Belicioiu Roxana, Olteanu Ioana
Optisan Laser Clinic, Cluj-Napoca, Romania.
Rom J Ophthalmol. 2017 Jan-Mar;61(1):18-22. doi: 10.22336/rjo.2017.4.
To compare the safety and intraoperative difficulties of two capsulorhexis techniques for white intumescent cataract: Femtolaser-assisted capsulorhexis and manual capsulorhexis performed in 2-3 stages, with the Utrata forceps. A prospective comparative study that included 28 eyes divided into 2 equal groups in which capsulorhexis was performed by using the 2 methods. In the first group, the capsulorhexis was executed by using LenSx Femtolaser. In the second group, an Utrata forceps was used to perform a manual 2-3 steps capsulorhexis as follows: a small 2-3 mm capsulorhexis was performed after the staining of the anterior capsule with Trypan Blue along with a good pressurization with viscoelastic substance. The liquefied cortex was aspirated, followed by the enlargement of the capsulorhexis. In some cases, the enlargement was made after IOL implantation. In the Femtolaser group, the capsule was completely detached in 13 cases and only in one case, the capsule had a few bridges which detached easily, without endangering the capsulorhexis integrity. Its size was 4,9 mm in all cases. In the group in which capsulorhexis was performed with the Utrata forceps in 2-3 stages, this was complete, circular and relatively well centered in all cases, but the size varied between 4,5 and 5,5 mm. Femtosecond laser-assisted capsulorhexis was round, well centered and of a desired size of 4,9 mm. The manual capsulorhexis with the Utrata forceps depends on the surgeon's skill and experience and requires a good local anesthesia, the coloring of the anterior capsule with Tripan Blue, using a large quantity of cohesive viscoelastic substances and sometimes using micro incision forceps for helpful maneuvers. The size and centering of the capsulorhexis are not always identical with the intended ones.
飞秒激光辅助撕囊和使用Utrata镊分2 - 3个阶段进行的手动撕囊。一项前瞻性对照研究，纳入28只眼并分为2组，每组14只眼，分别采用这两种方法进行撕囊。第一组使用LenSx飞秒激光进行撕囊。第二组使用Utrata镊进行手动2 - 3步撕囊，具体如下：用台盼蓝对前囊染色后，在良好的粘弹剂加压下制作一个2 - 3mm的小撕囊。吸出液化的皮质，然后扩大撕囊。在某些情况下，在植入人工晶状体后再扩大撕囊。在飞秒激光组，13例中囊膜完全分离，仅1例囊膜有几条容易分离的桥连，未危及撕囊完整性。所有病例中撕囊大小均为4.9mm。在分2 - 3个阶段使用Utrata镊进行撕囊的组中，所有病例撕囊均完整、呈圆形且相对居中，但大小在4.5至5.5mm之间变化。飞秒激光辅助撕囊呈圆形、居中良好，大小为理想的4.9mm。使用Utrata镊进行手动撕囊取决于术者的技术和经验，需要良好的局部麻醉、用台盼蓝对前囊染色、使用大量粘性粘弹剂，有时还需使用微型镊子辅助操作。撕囊的大小和中心位置并不总是与预期一致。
