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 [Cl], 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% Cl, 0.01% to 0.62%). CONCLUSION: The results suggest high efficacy and safety of this femtosecond laser system in creating capsulotomies.