Comparison between FLACS and Nd:YAG laser in preventing the Argentinian flag sign in intumescent white cataracts

Coelho, Roberto Pinto; Neumann, Renata Zaltron; Messias, André

doi:10.1097/j.jcrs.0000000000001114

Cited by 5 publications

(3 citation statements)

References 6 publications

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“…Porwal et al performed Nd:YAG laser anterior capsulotomy before cataract surgery to relieve pressure within the capsule [9]. In recent years, with the development of femtosecond laser-assisted cataract surgery (FLACS), many ophthalmologists have begun using femtosecond laser instead of manual capsulorrhexis [10]. However, even with the latest FLACS technology, consistent capsulorrhexis cannot be guaranteed in the treatment of intumescent cataracts, and there have been several reports of Argentinian ag sign complications related to FLACS in intumescent cataracts [11].…”

Section: Discussionmentioning

confidence: 99%

“…Numerous newly reported techniques such as vacuum capsulorrhexis, modi ed two-step methods, and suture needle microcapsulotomy have also been attempted [16,17,18,19]. Although these methods have shown some effectiveness, they still cannot completely eliminate the risk of anterior capsule tears and varying degrees of Argentinian ag sign occurrence [10]. Therefore, to achieve successful continuous curvilinear capsulorhexis, it is necessary not only to reduce surface capsule tension and avoid triggering the Argentinian ag sign at the moment of initial capsular rupture but also to release pressure in the posterior chamber simultaneously with the formation of the capsulorrhexis to prevent extension of the tear.…”

Section: Discussionmentioning

confidence: 99%

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Prevention of Argentinian Flag Sign in Intumescent Cataracts Using Anterior Chamber Air Bubble and Cortical Fluid Release Techniques

Wang,

Zhang,

Hou

et al. 2024

Preprint

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Objective: To effectively avoide the occurrence of the Argentinian flag sign during the process of continuous, circular, and centered anterior capsulotomy (CCC) on the anterior capsule in cortically liquefied intumescent cataracts Methods: Preoperative examinations including slit-lamp examination, ocular A-scan ultrasonography, and UBM were conducted on 61 patients with intumescent cataracts. Cases with cortically liquefied intumescent cataracts were selected and after staining with indocyanine green, the anterior chamber air bubble technique was used to compress the anterior capsule, and liquefied cortex was aspirated using a puncture needle. CDVA and intraocular pressure were recorded on postoperative days 1, 1 week, 1 month, and 6 month. Intraoperative and postoperative complications were documented and analyzed. Results: Fifty eyes were identified as having cortically liquefied intumescent cataracts. No cases of the Argentinian flag sign occurred, and standard capsulorrhexis was achieved, facilitating smooth phacoemulsification. All patients achieved satisfactory outcomes at follow-ups of 1 day, 1 week, 1 month, and 6 month postoperatively. Mild corneal edema was observed in three cases on the first postoperative day, with no other complications noted. Conclusion: The anterior chamber air bubble technique combined with cortical fluid release technique can prevent the occurrence of the Argentinian flag sign in cortically liquefied intumescent cataracts, this method is simple, convenient and economic for the clinical promotion.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prevention of Argentinian Flag Sign in Intumescent Cataracts Using Anterior Chamber Air Bubble and Cortical Fluid Release Techniques

Wang,

Zhang,

Hou

et al. 2024

Preprint

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“…However, the surgeon has to be mindful that incomplete capsulotomy may occur in up to one-third of eyes from FLACS. [ 43 45 46 ] A comparative study by Titiyal et al between FLACS and CPCS ( n = 40 each) found that the release of white milky fluid during femtosecond laser delivery was significantly associated with an incomplete anterior capsulotomy (19 of 40 eyes, 47.5%). [ 78 ] Staining the anterior capsule with trypan blue after femtosecond laser can help identify micro-adhesions; care should be taken to ensure that is no posterior extension in the event of an anterior capsular tear.…”

Section: White Cataractsmentioning

confidence: 99%

Femtosecond laser-assisted cataract surgery for complex cataracts – A review

Chen,

Chee

2024

Indian Journal of Ophthalmology

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Since its inception in 2009, femtosecond laser-assisted cataract surgery (FLACS) has become an alternative to conventional phacoemulsification cataract surgery (CPCS). Clinical studies were unable to demonstrate superior visual outcomes, but revealed reduced endothelial cell loss. More recently, the cost-effectiveness of FLACS over CPCS in routine cataract surgeries has been challenged. However, the unique abilities of FLACS to customize anterior capsulotomies precisely, soften and fragment the nucleus without capsular bag stress, and create corneal incisions may have special utility in complex cataract and less-common scenarios. In this article, we review the unique role of FLACS in complex cataract surgeries and how it could play a role to improve the safety and predictability of nonroutine cataract surgery.

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Nd:YAG laser capsulotomy vs needle aspiration in intumescent cataracts: comparative study of complications and outcomes

Ceylan,

Aydin,

Karapapak

et al. 2024

J Cataract Refract Surg

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Purpose: The aim of this study is to compare the complications and postoperative outcomes of Nd:YAG laser anterior capsulotomy versus a needle aspiration approach for capsulorhexis in patients with intumescent cataracts. Setting: University of Health Sciences, Basaksehir Cam and Sakura City Hospital department of Ophthalmology, Istanbul, Turkey Design: Retrospective, cross-sectional study. Method: Intumescent cataract patients were divided into two groups. Group 1 (37 eyes) underwent Nd:YAG Laser capsulotomy pre-surgery, which reduced lens pressure. In group 2 (31 eyes), the capsulorhexis was completed by reducing the intralenticular pressure by needle aspiration and then gradually expanding the capsule. Demographics, pre/post-op parameters, complications, and surgical times were analyzed. Results: Evaluated were 68 eyes from 68 patients. Age and gender exhibited no significant differences between groups. Group 2 had more complications than Group 1 (p=0.041). Specifically, no capsular tear extensions were seen in Group 1, while four patients in Group 2 had tears extending to the lens periphery. Group 1 showed a significant decrease in surgical maneuvers and time (p=0.028), while no significant difference was found in effective phacoemulsification time (p=0.076). Conclusion: Nd: YAG laser capsulotomy effectively prevented capsular extensions and reduced surgical time in intumescent cataracts. This technique provides a safe alternative to traditional methods, potentially reducing intraoperative risks and improving surgical efficiency. The findings support Nd: YAG laser anterior capsulotomy as a viable approach for capsulorhexis in intumescent cataracts, emphasizing its potential benefits in reducing complications and enhancing surgical outcomes.

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Comparison between FLACS and Nd:YAG laser in preventing the Argentinian flag sign in intumescent white cataracts

Cited by 5 publications

References 6 publications

Prevention of Argentinian Flag Sign in Intumescent Cataracts Using Anterior Chamber Air Bubble and Cortical Fluid Release Techniques

Prevention of Argentinian Flag Sign in Intumescent Cataracts Using Anterior Chamber Air Bubble and Cortical Fluid Release Techniques

Femtosecond laser-assisted cataract surgery for complex cataracts – A review

Nd:YAG laser capsulotomy vs needle aspiration in intumescent cataracts: comparative study of complications and outcomes

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