gms | German Medical Science

Purpose: To describe a new technique for performing anterior and posterior femtosecond laser-assisted capsulotomies in infants with congenital cataracts

Methods: Anterior laser capsulotomy on a 4 month old infant with congenital nuclear cataract was performed with a laser for cataract surgery (Catalys, OptiMedica, Sunnyvale, CA). The anterior capsule and cataract were removed. The sterile, two piece non-applanating liquid optics interface made it possible to re-dock the laser system to the eye for posterior capsulotomy. The integrated 3-dimensional spectral domain optical coherence tomography visualized the posterior capsule, allowing a centered central posterior capsulotomy followed by mechanical anterior vitrectomy. The posterior capsule was removed.

Results: Anterior and posterior capsulotomy were completed with the laser and removed successfully. The non-applanating, low intraocular pressure patient interface enabled the procedure to be completed without complications. Because of the soft cataractous lens, no fragmentation was necessary. Bimanual irrigation/aspiration was performed to remove the cortex and the nucleus. At the end of surgery a silicone contact lens was placed on the eye for visual rehabilitation. Total treatment time was 31 minutes. No intraoperative or postoperative complications were observed in the 3 month follow-up.

Conclusions: The use of a femtosecond laser with a non-applanating interface enables successful performance of precisely centered, concentric, and circular anterior and posterior capsulotomies. This holds great potential for use in infants with congenital cataracts.