Laser-Assisted Capsulotomy Centration: A Prospective Trial Comparing Pupil Versus OCT-Based Scanned Capsule Centration

Abstract

Purpose: To investigate different capsulotomy centration methods for femtosecond laser-assisted cataract surgery. The overlap between intraocular lens (IOL) optic and lens capsule was measured with different centration methods and IOL types.

Methods: This was a prospective randomized clinical trial. Patients with cataract scheduled for femtosecond laser-assisted cataract surgery were assigned to one of four treatment groups: optical coherence tomography (OCT)-based scanned capsule centration (SCC) and three-piece IOL (SCC with three-piece IOL); scanned capsule centration and plate-haptic IOL (SCC with plate-haptic IOL); pupil centration (PC) and three-piece IOL (PC with three-piece IOL); or PC and plate-haptic IOL (PC with plate-haptic IOL). At the end of surgery, the overlap between the IOL optic and capsular bag was measured.

Results: The results of 160 patients were evaluated (n = 40 in each group). There was no difference in age (P = .27), sex (P = .18), the number of treated left and right eyes (P = .64), or cataract grade (P = .06). With the new SCC method (capsulotomy diameter: 5 mm), a complete overlap was achieved in all cases in both SCC groups. The overlap was also complete in all cases with PC and plate-haptic IOLs. In the PC with three-piece IOL group, the overlap was incomplete in 3 eyes.

Conclusions: The SCC method helps to achieve a 360° overlap in all eyes independent of the IOL type. A complete 360° overlap was achieved in all cases up to a calculated capsulotomy diameter of 5.1 mm with this new method. [J Refract Surg. 2017;33(2):74-78.].