Take-home message: Research presented in this article found anterior capsulotomy to be the main trigger for an increase of prostaglandins in aqueous humor immediately after laser-assisted cataract surgery. Optimised energy settings in combination with NSAIDs might therefore help reduce laser-induced miosis.
The introduction of image-guided femtosecond lasers have resulted in several benefits, including a reduction in ultrasound energy and more precise capsulotomies.1-4 However, for the first time, these devices also treat intraocular tissue, so their intraocular effects remain largely unknown. Several studies have reported the occurrence of laser-induced miosis shortly after laser treatment, with varying frequencies.5-7
Prostaglandins (especially prostaglandin E2) play a role in inflammation-induced miosis and an increase in intraocular prostaglandin concentration immediately after laser treatment has previously been demonstrated.8 However, prior to the publication of the prospective study described in this article, which was carried out by Drs Tim Shultz, Stephanie C. Joachim, Mathias Stellbogen and Burkhard Dick,9 it was unclear which step of laser-assisted cataract surgery specifically causes release of prostaglandins. Understanding the specific mechanism involved in prostaglandin release is important as it can help us reduce its occurrence.
Assessing the relationship between prostaglandin concentration and FLACS
The purpose of the study was to investigate a possible correlation between intraocular prostaglandin concentrations and partial steps of laser-assisted cataract surgery. Specifically, the researchers were looking to see whether it was the fragmentation of the lens or the capsulotomy that induced inflammation after femtosecond laser-assisted surgery (FLACS).10-13