Comparison of Diathermic high-frequency capsulorhexis and Femtosecond laser-assisted capsulorrhexis in white cataract surgery

Aim: To compare the integrity, roundness and diameter of the capsulotomy in the white cataract between femtosecond laser assisted capsulotomy and high-frequency capsulorhexis.Methods: The prospective study included 32 patients with white-nuclear cataracts, 16 of whom underwent femtosecond capsulorhexis and another 16 underwent diathermic high-frequency capsulorhexis. The integrity roundness and diameter of the capsulorhexis post-operation were compared.Results: Femtosecond group obtained 6 cases(37.5%)of complete capsular. No anterior capsule tear occurred. Diathermy high-frequency achieved continuous complete capsulor in 3 eyes(18.75%) and anterior capsule was teared in 13 eyes(81.25%). The femtosecond group has a mean capsular diameter of 5.4 mm, and the diathermic high-frequency group has an average capsular diameter of 6 mm. No posterior capsule tear occurred in both surgical procedures. Conclusions: Femtosecond laser-assisted cataract surgery can achieve high capsulor integrity and stable capsulorhexis diameter. Compared with the diathermic high-frequency capsulorhexis, the frequency of injecting the viscoelastic agent was reduced, and the tear of the capsule was less likely to occur. The continuous complete capsular(CCC) by femtosecond laser is more round, more complete ,more controllable and smoother than diathermy high-frequency(DHC).

Comparison of Sulcus Implantation of Single-Piece Hydrophilic Foldable Acrylic and Polymethylmethacrylate Intraocular Lenses in Eyes with Posterior Capsule Tear during Phacoemulsification Surgery

Purpose To compare the results of sulcus implantation of acrylic and poly(methylmethacrylate) (PMMA) intraocular lens (IOL) in eyes with posterior capsule tear during phacoemulsification surgery. Methods In all eyes a posterior capsule tear developed during phacoemulsification surgery and an IOL to the ciliary sulcus was implanted primarily. A total of 89 eyes of 88 patients received hydrophilic foldable acrylic IOL (acrylic group). A total of 72 eyes of 72 patients received PMMA IOL (PMMA group). The mean age was 67.1 years and 68.1 years and postoperative follow-up period was 19.2 months and 17.9 months in acrylic and PMMA groups, respectively. Results Temporary corneal edema appeared in 33 eyes and 26 eyes, elevation of intraocular pressure in 17 eyes and 12 eyes, anterior chamber inflammatory reaction in 5 eyes and 5 eyes, clinical cystoid macular edema in 7 eyes and 12 eyes, and decentered IOL in 4 eyes and 3 eyes in acrylic and PMMA groups, respectively. Late postoperative endophthalmitis developed in two eyes of the PMMA group. Rhegmatogenous retinal detachment developed in one eye in each group. Final best-corrected visual acuities were 5/10 and above in 73 eyes (82.02%) in the acrylic group and 5/10 and above in 42 eyes (58.33%) in the PMMA group. Postoperative final induced astigmatism was 0.5±0.5 D (SD) in the acrylic group and 1.11±0.65 D (SD) in the PMMA group (p=0.0001) (independent samples t-test). Conclusions Increased astigmatism is more frequently seen in the PMMA group. The implantation of foldable acrylic IOL in the sulcus after posterior capsule tear maintains the advantages of small incision surgery.