Pulsed electron avalanche knife for capsulotomy in congenital and mature cataract

Abstract

The pulsed electron avalanche knife (PEAK-fc, Carl Zeiss Meditec) is an electrosurgical cutting device that allows precise "cold" and traction-free tissue dissection. We describe its applicability and safety for anterior capsulotomy in a child with congenital cataract and an adult patient with mature cataract. The PEAK-fc was set at a voltage of 600 V and a pulse repetition rate of 80 Hz. Anterior capsulotomies were successfully and safely performed in both cases, with the edges of capsulotomies appearing sharp and showing only limited collateral damage. The PEAK-fc appears to be a helpful cutting device for complicated cases of cataract surgery, especially for mature and congenital cataracts.

Femtosecond laser capsulotomy

“…28,30,31 Another electrosurgical device, the pulsed-electron avalanche knife, can produce a capsulotomy without thermal damage or radial tears. [32][33][34] Nevertheless, these are still manual procedures and as such, accompanied by the inherent difficulties of producing an accurately centered, sized, and shaped capsulotomy.…”

Performance of the Acri.Smart 46S intraocular lens in pediatric microincision cataract surgery

“…11 The rate of significant PCO formation during the follow-up period was 35% in the subgroup of 26 eyes with an intact posterior capsule at the end of cataract surgery. This rate is comparable to results published by Jensen et al 12 in 2002, in which 40% of pediatric eyes with an intended intact posterior capsule developed PCO.…”

“…For the anterior capsulotomy, a bent 25-gauge cannula, a Diacapsutom (ERBE Elektromedizin GmbH), or a pulsed electron avalanche knife (PEAKfc probe, Carl Zeiss Meditec) was slowly moved along the capsule in a circular manner (5.5 mm diameter), thereby avoiding tractional forces and pressure on the lens capsule. 11 The Diacapsutom works using high-frequency current cutting properties. After hydrodissection lens extraction using the Megatron S3 I/A mode was performed, the posterior capsule was polished.…”

Mechanized model to assess capsulorhexis resistance to tearing

“…These include radiofrequency diathermy and high-frequency capsulotomy, 7-12 vitrectorhexis, [13][14][15] the Fugo blade, 16,17 and more recently, a pulsed-electron avalanche knife. 18,19 When new methods of anterior capsulotomy for cataract surgery are developed, the morphologic aspect of the edge of the capsulotomy opening should be evaluated using methods such as high-magnification light microscopy 17 or scanning electron microscopy. 19 The regularity and smoothness of the edge and the presence of microtears or tissue damage can be appropriately assessed by these techniques.…”