The effect of femtosecond laser capsulotomy on the development of posterior capsule opacification.
OBJECTIVE
To evaluate and compare the effects of femtosecond laser-assisted anterior capsulotomy and manual anterior capsulorhexis on posterior capsule opacification (PCO) development.


METHODS
Femtosecond laser-assisted anterior capsulotomy was performed in 40 eyes of 40 patients (FS group) and manual anterior capsulorhexis was performed in 39 eyes of 39 patients (CCC group). An AcrySof one-piece hydrophobic acrylic intraocular lens (Alcon Laboratories, Inc., Fort Worth, TX) was implanted in all eyes. The PCO level was measured using Open-Access Systematic Capsule Assessment (OSCA) software 18 to 26 months after surgery. Postoperative intraocular lens position (ie, tilt and decentration) was measured using Scheimpflug images (Pentacam; Oculus Optikgeräte GmbH, Wetzlar, Germany).


RESULTS
There was no statistically significant difference in age, axial length, and follow-up time between the two groups (P > .05). Vertical tilt, horizontal and total decentration of intraocular lenses, and PCO proved to be significantly higher in the CCC group (P = .03, .04, .03, and .01, respectively). After adjusting for axial length and follow-up time, manual anterior capsulorhexis was found to be a significant predictor of higher PCO scores in the multivariable regression model (β: 0.33; 95% CI: 0.01 to 0.65; P = .04). Vertical tilt affected PCO scores after adjusting for axial length and follow-up time (β: 0.07; 95% CI: 0.01 to 0.12; P = .02). No capsulotomies were performed during follow-up in either group.


CONCLUSIONS
Femtosecond laser-assisted anterior capsulotomy proved to be a safe procedure for postoperative PCO rates. Due to better intraocular lens position, femtosecond laser-assisted anterior capsulotomy resulted in slightly decreased PCO scores; however, evaluating its clinical significance requires further studies.
Illés
I
Kovács
Kinga
K
Kránitz
Gábor L
GL
Sándor
Michael C
MC
Knorz
Eric D
ED
Donnenfeld
Rudy M
RM
Nuijts
Zoltán Z
ZZ
Nagy
D000368:Aged; D057866:Anterior Capsule of the Lens / Q000601:surgery*; D058442:Capsule Opacification / Q000209:etiology*; D019923:Capsulorhexis / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects* / Q000379:methods; D053844:Lasers, Solid-State; D019654:Lens Implantation, Intraocular; D008297:Male; D018918:Phacoemulsification; D011183:Postoperative Complications; D012189:Retrospective Studies