title: Analysis of femtosecond laser assisted capsulotomy cutting edges and manual capsulorhexis using environmental scanning electron microscopy.
abstract: Purpose. To investigate the structure and irregularity of the capsulotomy cutting edges created by two femtosecond (FS) laser platforms in comparison with manual continuous circular capsulorhexis (CCC) using environmental scanning electron microscopy (eSEM). Methods. Ten anterior capsulotomies were obtained using two different FS laser cataract platforms (LenSx, n = 5, and Victus, n = 5). In addition, five manual CCC (n = 5) were obtained using a rhexis forceps. The specimens were imaged by eSEM (FEI Quanta 400, OR, USA). Objective metrics, which included the arithmetic mean deviation of the surface (Sa) and the root-mean-square deviation of the surface (Sq), were used to evaluate the irregularity of both the FS laser capsulotomies and the manual CCC cutting edges. Results. Several microirregularities were shown across the FS laser capsulotomy cutting edges. The edges of manually torn capsules were shown, by comparison of Sa and Sq values, to be smoother (P < 0.05) than the FS laser capsulotomy edges. Conclusions. Work is needed to understand whether the FS laser capsulotomy edge microirregularities, not seen in manual CCC, may act as focal points for the concentration of stress that would increase the risk of capsular tear during phacoemulsification as recently reported in the literature.
authors.affiliation: Fondazione G.B. Bietti IRCCS, 00198 Rome, Italy.
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Serrao
authors.affiliation: CNR-IPCF Unit of Support of Cosenza, 87036 Rende, Italy ; Vision Engineering Italy Srl, 00198 Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lombardo
authors.affiliation: CNR-IPCF Unit of Support of Cosenza, 87036 Rende, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Desiderio
authors.affiliation: CAMO SpA, 20121 Milan, Italy.
authors.forename: Lucio
authors.initials: L
authors.lastname: Buratto
authors.affiliation: Fondazione G.B. Bietti IRCCS, 00198 Rome, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Schiano-Lomoriello
authors.affiliation: Azienda Ospedaliera San Giovanni-Addolorata, 00100 Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Pileri
authors.affiliation: Fondazione G.B. Bietti IRCCS, 00198 Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Lombardo