title: Electron microscopy of laser capsulotomy edge: Interplatform comparison.
abstract: OBJECTIVE
  To perform a morphological comparison of capsulotomy edges generated by commercially available femtosecond lasers with manual capsulorhexis.
  
  
  METHODS
  Private clinic.
  
  
  METHODS
  Experimental study.
  
  
  METHODS
  Capsules were collected using the following laser platforms and software versions: Lensx pre-soft-fit (version 2.16), Lensx post-soft-fit (version 2.20), Victus I (version 2.5), Victus II (version 2.7SP2), Catalys (version 2.15.13), and 10 manual. Scanning electron microscopy images were analyzed for the coefficient of variation (CoV) of pixilation along the capsule edge and homogeneity using gray-level co-occurrence matrix analysis. A qualitative assessment for anomalies, such as tags, was also made.
  
  
  RESULTS
  The mean CoV values from the regression analysis showed the manual edge (n = 10) (101.6% ± 0.6% [SD]) was smoother than the edges created with Lensx pre-soft-fit (105.2% ± 1.2%) (P<.001), Lensx post-soft-fit (102.7% ± 1.4%) (P=.04), Victus I (104.9% ± 0.9%) (P<.001), Catalys (104.5% ± 1.6%) (P<.001), and Victus II (104.7% ± 1.6%) platforms. All lasers (0.19 to 0.23) (P<.001) except the Lensx post-soft-fit (0.25 ± 0.03) (P=.23) generated less homogenous capsulotomies than the manual technique (0.27 ± 0.04). Tags occurred with Lensx pre-soft-fit (5/10), Lensx post-soft-fit (1/10), Victus I (1/4), and Victus II (3/10) platforms. Misdirected pulses were seen with the Catalys (4/10) and Victus II (4/10) platforms, which used fluid interfaces.
  
  
  CONCLUSIONS
  Laser capsulotomies are approaching the smoothness of the manual capsulorhexis. The Lensx post-soft-fit platform showed the least anomalies and the smallest difference for the CoV and homogeneity metrics compared with the manual method.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: From the Australian School of Advanced Medicine (Bala), Macquarie University, the Department of Computer Science (Xia), University of Sydney, and Personaleyes (Meades), Sydney, Australia. Electronic address: chandrabala.eye@gmail.com.
authors.forename: Chandra
authors.initials: C
authors.lastname: Bala
authors.affiliation: From the Australian School of Advanced Medicine (Bala), Macquarie University, the Department of Computer Science (Xia), University of Sydney, and Personaleyes (Meades), Sydney, Australia.
authors.forename: Yong
authors.initials: Y
authors.lastname: Xia
authors.affiliation: From the Australian School of Advanced Medicine (Bala), Macquarie University, the Department of Computer Science (Xia), University of Sydney, and Personaleyes (Meades), Sydney, Australia.
authors.forename: Kerrie
authors.initials: K
authors.lastname: Meades
mesh_terms: D000368:Aged; D057866:Anterior Capsule of the Lens / Q000601:surgery* / Q000648:ultrastructure*; D002387:Cataract Extraction; D006801:Humans; D053685:Laser Therapy; D054018:Lasers, Excimer; D054023:Lasers, Semiconductor; D019654:Lens Implantation, Intraocular; D008855:Microscopy, Electron, Scanning