Optimization of the femtosecond laser transection of the hydrophobic intraocular lens and long-term outcomes in clinical experience (initial experience)

Abstract

Purpose. To optimize the energy parameters of the FL assistance using the LenSx FL unit for transection of IOL made of hydrophobic material, as well as to develop a sparing surgical technique for the IOL removal from the anterior chamber.Material and methods. In the experimental part of the study, the femtosecond laser transection of IOL was carried out using the LenSx unit in different energies (1, 2, 4, 6, 8, 10µJ). The subsequent mechanical separation of IOL was evaluated according to a 4-point scale. Single IOL fragments after transection (n=3) were studied under experimental conditions using the optical light microscopy in 40 and X100 magnifications The preexplantation FL transection was performed under clinical conditions in one patient. The Evaluation of FL transsection of IOL was carried out using the electron microscope with magnification x47 and х800.Results. Under experimental conditions, the pulse energy levels (2, 4, 6, 8, 10 µJ) showed the similar efficiency of IOL transection. The level of energy 1µJ – manual separation of the IOL along the line of transection was impossible. High energy loads (8, 10µJ) entailed a change in the surface of IOL of unknown nature. In clinical conditions the technique of FL transection of IOL showed its safety and efficiency.Conclusion. Hydrophobic IOLs can be fragmented using the femtosecond laser.

Keywords

• intraocular lens
• femtosecond laser
• transection
• intraocular lens exchange
• femtosecond laser fragmentation
• intraocular lens explantation surgery
• refractive error.