Prevention of lens capsule opacification with ARC neodymium:YAG laser photolysis after phacoemulsification

Abstract

We describe a technique that uses a neodymium:YAG (Nd:YAG) laser photolysis system to prevent lens capsule opacification. The photolysis instrument consists of a 1064 nm Nd:YAG laser transmitted along a fiber-optic cable into a handpiece containing an angulated titanium plate that the laser beam strikes, creating plasma and a shockwave that exits the handpiece through an aperture. Under direct visualization, the shockwave is aimed at the inner surface of the anterior capsule, where it removes LECs and proteoglycan attachment molecules; the shockwave probably extends to the capsule fornix, destroying germinal epithelial cells. We report preliminary results in 12 eyes followed for approximately 2.5 years in which the treated nasal anterior capsule remained clear or with only slight opacity and the untreated temporal capsule developed moderate to severe opacification.

Preventing posterior capsule opacification

“…2 This technique has been used clinically in proof of concept and is presently in use in surgical practices in Europe and the United States. 3 George O. Waring III, MD, FRCOphth Atlanta, Georgia, USA Dr. Waring is a paid scientific advisor for A.R.C. Laser GmbH.…”