<p>Precision pulse capsulotomy in challenging cataract surgery cases</p>

Abstract

Purpose To evaluate the use of the precision pulse capsulotomy (PPC) device for challenging cataract surgery cases. Patients and methods This single-center retrospective case series study comprised of 43 eyes (from 35 patients) that were challenging cataract surgery cases with poorly dilated pupils, anterior subcapsular opacity, white cataract, brunescent cataract, and corneal opacity. This was conducted at the Busan Sungmo Eye Hospital (Busan, Republic of Korea) to assess the performance of the PPC device through a 2.2-mm clear corneal incision width, followed by the phacoemulsification technique and intracapsular intraocular lens fixation. The main outcome measurement was the anterior capsulotomy performance of the PPC device and the development of intraoperative complications. At postoperative 2 months, visual acuity, endothelial cell count, and refractive error were measured. Results No cases of anterior capsule tears or tags occurred. All 43 eyes received circular, 360-degree, free-floating, and appropriately sized anterior capsulotomies. During 2 months of follow up, no postoperative complications occurred in association with the PPC device. Conclusion The PPC device facilitated the creation of a precise, round, appropriately sized anterior capsulotomy in challenging cataract surgery cases. Further investigations are required to understand the long-term safety and efficacy of the PPC device.

Recent developments in anterior capsulotomy for cataract surgery

“…The study found that the procedure was useful for complex cases including traumatic cataracts, compromised anterior and posterior capsule, and intumescent cataracts [16]. Similarly, an article evaluating challenging cases exclusively (including poorly dilated pupils, white and brunescent cataracts, and corneal opacity) found that PPC was able to deliver correctly sized free-floating capsulotomies to all eyes ( n = 43) without any anterior capsule tears or tags or postoperative complications [17]. Another study found the same results where PPC was used in triple procedure keratoplasty in patients with small nondilating pupils ( n = 10) [18].…”

Clinical Results After Precision Pulse Capsulotomy

“…13 Previous clinical results have demonstrated the efficacy of the device. [14][15][16] As with the femtosecond laser systems, there is some evidence that an automated capsulotomy that does not induce zonular stress may be helpful in complicated cases. 15 The purpose of the current study was to retrospectively review refractive outcomes and complications in a high number of cases completed using the PPC device, comparing them to a similar set of cases completed using a manual CCC technique.…”

Automated Precision Pulse Capsulotomy Versus Manual Capsulorhexis In White Cataracts: Reduction In Procedural Time And Resource Utilization

“…PPC has been used successfully not just in routine cataract surgery but also in pediatric cataract surgery and in challenging cases with corneal opacities, small pupils, zonular pathologies, and trauma. [11][12][13][14][15] The learning curve has been reported to be favorable, and the experience of 4 surgeons has been described. 11 Several device operating principles underlying PPC creation suggest that this technology may also be useful in cases of white cataract.…”