Transection and explantation of intraocular lenses using femtosecond lasers

Modified Trisection Technique: One-Trip Explantation for Foldable Intraocular Lens

PURPOSE

We present a new technique that allows an intraocular lens to be explanted through the small incisions used in modern cataract surgery.

METHODS AND RESULTS

The intraocular lens optic is cut into three connected pieces at the 1-mm-wide end with scissors. Then, with the stabilizing counterforce provided by a pair of vitreoretinal forceps through a paracentesis, the middle piece is removed first, followed by the two side pieces connected with haptics flipped over at the connected part. These two parts overlap each other when passing through the incision, eventually resulting in the explantation of the intraocular lens, as an intact piece.

CONCLUSION

We believe this method provides a simple and effective way to remove intraocular lens through very small incisions, which could also reduce complications and hasten patient's recovery.

Application of Femtosecond Laser in Anterior Segment Surgery

Femtosecond laser (FSL) is a near-infrared laser that can create reliable and reproducible tissue cutting with minimal damage to adjacent tissue. As the laser can also create incisions with various orientations, depths, and shapes, it is expected to be a useful tool for anterior segment surgery, such as cornea, refractive, and cataract surgery. In this review, the authors will introduce the application of FSL in various anterior segment surgeries and discuss the results of studies regarding the efficacy and safety of FSL in cornea, refractive, and cataract surgery. Experimental studies regarding the potential use of FSL will also be introduced. The studies discussed in this review suggest that FSL may be a useful tool for improving the prognosis and safety of surgeries of the anterior segment.

An Experimental Study of Femto-Laser in Assisting Xenograft Acellular Cornea Matrix Lens Transplantation

Background

The aim of this study was to evaluate the feasibility of using a femto-laser in assisting xenograft cornea matrix lens transplantation in correcting ametropia, along with evaluating the effectiveness and predictability of this procedure.

Material/Methods

A corneal matrix pouch was prepared on the right eyes on 8 healthy New Zealand rabbits by a femto-laser that was also employed to perform small incision lenticule extraction (SMILE) on 8 bovine cornea matrix lenses (+6D). A lens was treated acellular and implanted into a right rabbit cornea matrix pouch. Surface inflammation was observed at 1, 2, 4, 8, 12, and 24 weeks after surgery. Anterior ocular segment optical coherence tomography (OCT), corneal topography, retinoscopy, and cornea endothelial cell enumeration were performed.

Results

All the surgeries were successfully performed without any complications. The hyperopia condition of the rabbit eyes transformed into myopia status at an early stage and gradually developed hyperopia. Diopter at 24 weeks after surgery was 1/3 of that before surgery. Central corneal thickness stabilized at 4 weeks after surgery. Anterior segment OCT showed a clear lens edge at early post-operative stage, and blurred edge at 24 weeks later, indicating gradual fusion with the rabbit corneal matrix.

Conclusions

Femto-laser assisted xenograft corneal matrix lens transplantation is safe and effective in correcting ametropia, with satisfactory predictability, thus providing novel choice for correcting ametropia.

Femtosecond Laser-Assisted Intraocular Lens Fragmentation: Low Energy Transection

PURPOSE

To describe a case of femtosecond laser-assisted hydrophobic intraocular lens transection.

METHODS

Case report.

RESULTS

Femtosecond laser-assisted transection of a one-piece acrylic hydrophobic intraocular lens for explantation via a small surgical incision was successfully performed with low energy parameters.

CONCLUSIONS

This case illustrates a novel and effective clinical application of the femtosecond laser. [J Refract Surg. 2017;33(9):646-648.].