title: Optical coherence tomography and 3-dimensional confocal structured imaging system-guided femtosecond laser capsulotomy versus manual continuous curvilinear capsulorhexis.
abstract: OBJECTIVE
  To compare the features of capsulotomy obtained during femtosecond laser-assisted cataract surgery with those of continuous curvilinear capsulorhexis (CCC) obtained using a standard manual technique.
  
  
  METHODS
  Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy.
  
  
  METHODS
  Prospective randomized clinical study.
  
  
  METHODS
  Candidates for cataract extraction were randomized into 1 of 3 groups as follows: Lensx femtosecond laser-assisted cataract surgery capsulotomy (laser group 1), Lensar femtosecond laser-assisted cataract surgery capsulotomy (laser group 2), and manual CCC (manual group).
  
  
  RESULTS
  Each group comprised 30 eyes (30 patients). The capsulotomies in laser group 1 and laser group 2 showed significantly better circularity than the manual CCCs at 7 days (P<.001). There was a significant correlation between the intended versus achieved capsulotomy size in the 2 laser groups. Both laser groups had better intraocular lens (IOL) centration than the manual group at all timepoints (P<.001). Between-group differences in uncorrected and corrected distance visual acuities were not statistically significant. The residual spherical equivalent and mean absolute error were statistically significantly smaller in the 2 laser groups than in the manual group (P=.038) and increased significantly over time in all the groups (P<.001).
  
  
  CONCLUSIONS
  Femtosecond laser capsulotomies showed better circularity with more predictable size than manual CCCs. In addition, IOL centration was better immediately after surgery and over time with better refractive results in the 2 laser groups.
authors.affiliation: From the Ophthalmology Clinic (L. Mastropasqua, Toto, Mattei, Vecchiarino, Nubile), Department of Medicine and Science of Ageing, Department of Neuroscience and Imaging (Navarra), Institute of Advanced Biomedical Technologies, and Department of Experimental and Clinical Sciences (Di Nicola), Laboratory of Biostatistics, University G. D'Annunzio Chieti-Pescara, Chieti, and the Ophthalmic Clinic (A. Mastropasqua), Campus Biomedico, University of Rome, Rome, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Mastropasqua
authors.affiliation: From the Ophthalmology Clinic (L. Mastropasqua, Toto, Mattei, Vecchiarino, Nubile), Department of Medicine and Science of Ageing, Department of Neuroscience and Imaging (Navarra), Institute of Advanced Biomedical Technologies, and Department of Experimental and Clinical Sciences (Di Nicola), Laboratory of Biostatistics, University G. D'Annunzio Chieti-Pescara, Chieti, and the Ophthalmic Clinic (A. Mastropasqua), Campus Biomedico, University of Rome, Rome, Italy. Electronic address: totolisa@hotmail.com.
authors.forename: Lisa
authors.initials: L
authors.lastname: Toto
authors.affiliation: From the Ophthalmology Clinic (L. Mastropasqua, Toto, Mattei, Vecchiarino, Nubile), Department of Medicine and Science of Ageing, Department of Neuroscience and Imaging (Navarra), Institute of Advanced Biomedical Technologies, and Department of Experimental and Clinical Sciences (Di Nicola), Laboratory of Biostatistics, University G. D'Annunzio Chieti-Pescara, Chieti, and the Ophthalmic Clinic (A. Mastropasqua), Campus Biomedico, University of Rome, Rome, Italy.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Mattei
authors.affiliation: From the Ophthalmology Clinic (L. Mastropasqua, Toto, Mattei, Vecchiarino, Nubile), Department of Medicine and Science of Ageing, Department of Neuroscience and Imaging (Navarra), Institute of Advanced Biomedical Technologies, and Department of Experimental and Clinical Sciences (Di Nicola), Laboratory of Biostatistics, University G. D'Annunzio Chieti-Pescara, Chieti, and the Ophthalmic Clinic (A. Mastropasqua), Campus Biomedico, University of Rome, Rome, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Vecchiarino
authors.affiliation: From the Ophthalmology Clinic (L. Mastropasqua, Toto, Mattei, Vecchiarino, Nubile), Department of Medicine and Science of Ageing, Department of Neuroscience and Imaging (Navarra), Institute of Advanced Biomedical Technologies, and Department of Experimental and Clinical Sciences (Di Nicola), Laboratory of Biostatistics, University G. D'Annunzio Chieti-Pescara, Chieti, and the Ophthalmic Clinic (A. Mastropasqua), Campus Biomedico, University of Rome, Rome, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Mastropasqua
authors.affiliation: From the Ophthalmology Clinic (L. Mastropasqua, Toto, Mattei, Vecchiarino, Nubile), Department of Medicine and Science of Ageing, Department of Neuroscience and Imaging (Navarra), Institute of Advanced Biomedical Technologies, and Department of Experimental and Clinical Sciences (Di Nicola), Laboratory of Biostatistics, University G. D'Annunzio Chieti-Pescara, Chieti, and the Ophthalmic Clinic (A. Mastropasqua), Campus Biomedico, University of Rome, Rome, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Navarra
authors.affiliation: From the Ophthalmology Clinic (L. Mastropasqua, Toto, Mattei, Vecchiarino, Nubile), Department of Medicine and Science of Ageing, Department of Neuroscience and Imaging (Navarra), Institute of Advanced Biomedical Technologies, and Department of Experimental and Clinical Sciences (Di Nicola), Laboratory of Biostatistics, University G. D'Annunzio Chieti-Pescara, Chieti, and the Ophthalmic Clinic (A. Mastropasqua), Campus Biomedico, University of Rome, Rome, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Di Nicola
authors.affiliation: From the Ophthalmology Clinic (L. Mastropasqua, Toto, Mattei, Vecchiarino, Nubile), Department of Medicine and Science of Ageing, Department of Neuroscience and Imaging (Navarra), Institute of Advanced Biomedical Technologies, and Department of Experimental and Clinical Sciences (Di Nicola), Laboratory of Biostatistics, University G. D'Annunzio Chieti-Pescara, Chieti, and the Ophthalmic Clinic (A. Mastropasqua), Campus Biomedico, University of Rome, Rome, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Nubile
mesh_terms: D000368:Aged; D057866:Anterior Capsule of the Lens / Q000601:surgery*; D019923:Capsulorhexis / Q000379:methods*; D004311:Double-Blind Method; D006801:Humans; D021621:Imaging, Three-Dimensional; D053685:Laser Therapy / Q000379:methods*; D019654:Lens Implantation, Intraocular; D018918:Phacoemulsification / Q000379:methods*; D011446:Prospective Studies; D019591:Pseudophakia / Q000503:physiopathology; D012029:Refraction, Ocular / Q000502:physiology; D025321:Surgery, Computer-Assisted / Q000379:methods*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology