title: Calculation of ophthalmic viscoelastic device-induced focus shift during femtosecond laser-assisted cataract surgery.
abstract: OBJECTIVE
  To assess if a change in refractive index of the anterior chamber during femtosecond laser-assisted cataract surgery can affect the laser beam focus position.
  
  
  METHODS
  The index of refraction and chromatic dispersion of six ophthalmic viscoelastic devices (OVDs) was measured with an Abbe refractometer. Using the Gullstrand eye model, the index values were used to predict the error in the depth of a femtosecond laser cut when the anterior chamber is filled with OVD. Two sources of error produced by the change in refractive index were evaluated: the error in anterior capsule position measured with optical coherence tomography biometry and the shift in femtosecond laser beam focus depth.
  
  
  RESULTS
  The refractive indices of the OVDs measured ranged from 1.335 to 1.341 in the visible light (at 587 nm). The error in depth measurement of the refilled anterior chamber ranged from -5 to +7 μm. The OVD produced a shift of the femtosecond laser focus ranging from -1 to +6 μm. Replacement of the aqueous humor with OVDs with the densest compound produced a predicted error in cut depth of 13 μm anterior to the expected cut.
  
  
  CONCLUSIONS
  Our calculations show that the change in refractive index due to anterior chamber refilling does not sufficiently shift the laser beam focus position to cause the incomplete capsulotomies reported during femtosecond laser-assisted cataract surgery.
authors: Ophthalmic Biophysics Center, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami, Florida, United States Biomedical Optics and Laser Laboratory, Department of Biomedical Engineering, University of Miami College of Engineering, Miami, Florida, United States.
authors: Carolina P
authors: CP
authors: de Freitas
authors: Ophthalmic Biophysics Center, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami, Florida, United States Anne Bates Leach Eye Hospital, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States.
authors: Florence
authors: F
authors: Cabot
authors: Ophthalmic Biophysics Center, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami, Florida, United States Biomedical Optics and Laser Laboratory, Department of Biomedical Engineering, University of Miami College of Engineering, Miami, Florida, United States.
authors: Fabrice
authors: F
authors: Manns
authors: Anne Bates Leach Eye Hospital, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States.
authors: William
authors: W
authors: Culbertson
authors: Ophthalmic Biophysics Center, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami, Florida, United States Anne Bates Leach Eye Hospital, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States.
authors: Sonia H
authors: SH
authors: Yoo
authors: Ophthalmic Biophysics Center, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami, Florida, United States Biomedical Optics and Laser Laboratory, Department of Biomedical Engineering, University of Miami College of Engineering, Miami, Florida, United States Vision Cooperative Research Center, Brien Holden Vision Institute, University of New South Wales, Sydney, Australia.
authors: Jean-Marie
authors: JM
authors: Parel
mesh_terms: D002387:Cataract Extraction / Q000379:methods*; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D007903:Lens Capsule, Crystalline / Q000473:pathology / Q000601:surgery; D007910:Lenses, Intraocular / Q000009:adverse effects*; D008962:Models, Theoretical; D012029:Refraction, Ocular; D012030:Refractive Errors / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D041623:Tomography, Optical Coherence; D055682:Viscoelastic Substances / Q000009:adverse effects*
chemical_list: D055682:Viscoelastic Substances
keywords: capsulotomy; cataract surgery; femtosecond laser; ophthalmic viscoelastic device; optical coherence tomography
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