gms | German Medical Science

29. Internationaler Kongress der Deutschen Ophthalmochirurgen (DOC)

09.06. - 11.06.2016, Nürnberg

A new technique of automated capsulotomy

Meeting Abstract

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  • Vance Thompson - Vance Thompson Vision, Sioux Falls

29. Internationaler Kongress der Deutschen Ophthalmochirurgen. Nürnberg, 09.-11.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocH 7.2.4

doi: 10.3205/16doc012, urn:nbn:de:0183-16doc0123

Veröffentlicht: 3. Juni 2016

© 2016 Thompson.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe



Purpose: To present test data and initial clinical results for a new disposable capsulotomy device called ZeptoTM (Mynosys Inc. Fremont, CA. USA).

Methods: Miyake-Apple imaging to examine zonular effects and scanning electron microscopy (SEM) to investigate capsulotomy edge morphology. Rabbit GLP study comparing ocular condition after ZeptoTM or CCC. Comparison of ZeptoTM edge strength and extensibility to CCC or femtosecond laser in paired cadaver eyes. 10 patients (49 to 85 y.o.) with lens cataract received ZeptoTM capsulotomy, phacoemulsification and a one-piece acrylic IOL.

Results: The ZeptoTM disposable handpiece with capsulotomy tip is connected to a console. The tip has a soft, clear silicone suction cup within which a circular superelastic nitinol capsulotomy element is embedded. The tip is elongated to fit through a 2.2 mm incision and allowed to regain to its circular shape the anterior chamber. After centering on the pupil or visual axis, suction is applied followed by a 4 milliseconds multipulse algorithm to create round circular capsulotomies. Suction is reversed and the ZeptoTM tip is retrieved from the anterior chamber.

ZeptoTM produces consistently round capsulotomies with no zonular stress. The capsulotomy edge is smooth by SEM with a slight eversion of the defect-free underside of the capsule. Rabbit eyes with ZeptoTM capsulotomies had a benign post-op course with no difference to CCC eyes. The ZeptoTM edge was 3-4 times stronger than the CCC (P=0.012) and the femtosecond laser edge (P=0.012). ZeptoTM edges were also more extensible than CCC (P <0.01) and femtosecond laser edges (P <0.01). (Wilcoxon matched-airs signed ranks test.)

Complete, free-floating capsulotomies were achieved in all 10 patients. ZeptoTM performed well in challenging cases including in 3 patients with pterygium limiting capsule visualization, 2 patients with dense cataracts and poor red reflex, and 2 patients with poor pupil dilation. No capsulotomy related adverse events were noted up to 4 weeks after surgery.

Conclusions: ZeptoTM produces consistent, round capsulotomies that are stronger and more extensible than that of CCC or femtosecond laser. ZeptoTM performed well in initial clinical study and appears to have good potential for safe, consistent capsulotomies in challenging cases.