Efficacy of anterior capsulotomy creation in femtosecond laser–assisted cataract surgery

Purpose To report the rate of complete capsulotomies without adhesions and anterior capsule tears using the Catalys femtosecond laser. Setting Moorfields Eye Hospital, London, United Kingdom. Design Prospective consecutive case series. Methods This study evaluated femtosecond laser–assisted cataract cases performed between January 2013 and March 2014. Platform software versions 2.15, 2.15.13, and 2.20 were used. Results A complete 360-degree capsulotomy (without adhesions or bridging tags, so free floating at the entire capsulotomy circumference) was present in 998 (99.8%) of the 1000 cases (95% confidence interval [CI], 99.2% to >99.9%). None of these cases had intraoperative anterior capsule tears. In the 2 cases in which the capsulotomy was incomplete, 1 was due to the laser being aborted during capsulotomy and was completed manually without incident. The second was in a routine procedure with a single adhesion (bridging tag) at capsulotomy removal and a radial tear (not extending to the posterior capsule) identified after nucleus removal. Thus, the rate of anterior capsule tear was 0.1% (1 in 1000) (95% CI, 0.01% to 0.62%). Conclusion The results suggest high efficacy and safety of this femtosecond laser system in creating capsulotomies. Financial Disclosures Dr. Stevens received personal fees and grants from Optimedica, Inc. during the conduct of the study and personal fees from Optimedica, Inc. outside the submitted work. No other author has a financial or proprietary interest in any material or method mentioned.