Managing mature white cataracts

Boston-The efficacy and safety of femtosecond laser for cataract surgery has been questioned-the presumption being that the technology will not be able to penetrate the opaque lens cataractous material, said Sudhank Bharti, MS.

This femtosecond laser study indicated that the laser easily removed mature, white cataracts followed by IOL implantation. The laser performs three steps: capsulorhexis, nucleotomy, and creation of corneal ports.

Bharti, from the Bharti Eye Foundation, New Delhi, India, reported using femtosecond laser technology in eight eyes with advanced cataracts for which he performed a normal routine cataract extraction procedure.

He demonstrated one of the cases in which a hard cataract in which the pupil would not dilate. He reduced the capsulotomy size and lens chop size. In cases with softer cataracts, he uses a 1.5-mm incision, but increased it to 1.8 mm and ultimately to 1.9 or 2.0 mm. Although the nucleotomy was not to the complete depth, the division of the nucleus was possible. When the laser started firing, he described explosion of fluid from inside the tumescent cataract.

Bharti noted that the capsulotomies and incisions were all performed successfully. Partial nucleotomy was helpful in these cases. There was no extension of the capsulotomy despite the high intralenticular pressure in tumescent white mature cataracts.

“Femtosecond laser-assisted cataract surgery is an efficient way to manage mature white cataracts,” according to Bharti.

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