title: Comparison of intra-ocular pressure changes with liquid or flat applanation interfaces in a femtosecond laser platform.
abstract: Cataract surgery is the most common surgical procedure and femtosecond laser assisted cataract surgery (FLACS) has gained increased popularity. FLACS requires the application of a suction device to stabilize the laser head and focus the laser beam accurately. This may cause a significant escalation in intra-ocular pressure (IOP), which poses potential risks for patients undergoing cataract surgery. In this study we aimed to assess the effect of the Ziemer LDV Z8 femtosecond cataract machine on IOP. We demonstrated through a porcine model that IOP was significantly higher with a flat interface but could be abrogated by reducing surgical compression and vacuum. Pressure was lower with a liquid interface, and further altering angulation of the laser arm could reduce the IOP to 36 mmHg. A pilot series in patients showed comparable pressure rises with the porcine model (30 mmHg). These strategies may improve the safety profile in patients vulnerable to high pressure when employing FLACS with the Ziemer LDV Z8.
authors.affiliation: Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, Singapore.|Singapore National Eye Centre, Singapore.
authors.forename: G P
authors.initials: GP
authors.lastname: Williams
authors.affiliation: Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, Singapore.
authors.forename: H P
authors.initials: HP
authors.lastname: Ang
authors.affiliation: Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, Singapore.
authors.forename: B L
authors.initials: BL
authors.lastname: George
authors.affiliation: Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, Singapore.
authors.forename: Y C
authors.initials: YC
authors.lastname: Liu
authors.affiliation: Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, Singapore.
authors.forename: G
authors.initials: G
authors.lastname: Peh
authors.affiliation: Oftalmosalud Instituto de Ojos, Lima, Peru.
authors.forename: L
authors.initials: L
authors.lastname: Izquierdo
authors.affiliation: Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, Singapore.|Singapore National Eye Centre, Singapore.|Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.|Ophthalmology Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore.
authors.forename: D T
authors.initials: DT
authors.lastname: Tan
authors.affiliation: Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, Singapore.|Singapore National Eye Centre, Singapore.|Ophthalmology Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore.|Department of Clinical Sciences, Duke-NUS Graduate Medical School, Singapore.
authors.forename: J S
authors.initials: JS
authors.lastname: Mehta
mesh_terms: D000368:Aged; D000818:Animals; D002386:Cataract / Q000628:therapy*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D007834:Lasers / Q000706:statistics & numerical data*; D013552:Swine; D014065:Tonometry, Ocular / Q000295:instrumentation*