Department of Ophthalmology, University Eye Hospital, Ludwig-Maximilians-University, Mathildenstr. 8, 80336, Munich, Germany.
Department of Ophthalmology, Goethe-University, Frankfurt am Main, Germany.
Sci Rep. 2021 Dec 24;11(1):24427. doi: 10.1038/s41598-021-04054-5.
Studying anterior lens capsule cutting edge profiles from femtosecond laser-assisted capsulotomy procedures performed before and after lens fragmentation. Twenty eyes (10 patients) with age-related cataract underwent femtosecond laser-assisted surgery (FLACS) using the Ziemer Z8 platform. First step of laser surgery was either capsulotomy (group first) or fragmentation (group second). One eye of each patient was assigned randomly, the second eye treated with the different sequence of procedures. After anterior capsule removal, tissue was fixed in cacodylate-buffered solution and cutting-edge profiles were analysed using scanning electron microscopy (SEM). All cases had cataract grade 2 and 3 based on LOCS III grading. SEM analysis showed more smooth edges in the first group, especially in cases with pseudoexfoliation (P = 0.037); more tags and bridges and a significant number of staggered cutting patterns (7 out of 10 cases) in the second group. All cases evolved the same microgroves with "valleys and mountains " as signs of the photodisruption process. Femtosecond laser capsulotomy should be performed before lens fragmentation minimizing the rate of cutting errors. Especially in eyes with advanced cataract, as intracapsular pressure may increase due to lens fragmentation without anterior capsular opening.
研究飞秒激光辅助囊切开术前后晶状体碎片形成前晶状体囊边缘轮廓。20 只眼（10 例）年龄相关性白内障患者接受了 Ziemer Z8 平台的飞秒激光辅助手术（FLACS）。激光手术的第一步是囊切开术（第一组）或晶状体碎裂术（第二组）。每个患者的一只眼被随机分配，第二只眼采用不同的手术顺序进行治疗。前囊切除后，组织固定在卡可酸缓冲液中，并用扫描电子显微镜（SEM）分析边缘轮廓。所有病例均根据 LOCS III 分级为 2 级和 3 级白内障。SEM 分析显示，第一组的边缘更光滑，尤其是在假性剥脱（P=0.037）的情况下；第二组的标签和桥更多，并且存在明显的交错切割模式（10 例中有 7 例）。所有病例均出现相同的微凹槽，表现为光离解过程的“山谷和山脉”特征。飞秒激光囊切开术应在晶状体碎裂之前进行，以最大程度地降低切割错误的发生率。特别是在白内障晚期的眼睛中，由于晶状体碎裂而没有前囊口开放，可能会增加囊内压。
