AUTHOR=Zhu Yanan , Shi Kexin , Yao Ke , Wang Yuyan , Zheng Sifan , Xu Wen , Chen Peiqing , Yu Yibo , Shentu Xingchao 

TITLE=Parameters of Capsulorrhexis and Intraocular Lens Decentration After Femtosecond and Manual Capsulotomies in High Myopic Patients With Cataracts

JOURNAL=Frontiers in Medicine

VOLUME=Volume 8 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.640269

DOI=10.3389/fmed.2021.640269

ISSN=2296-858X

ABSTRACT=PURPOSE: To compare the parameters of capsulorrhexis and intraocular lens decentration after femtosecond laser capsulotomy and manual continuous curvilinear capsulorrhexis in high myopic patients with cataracts.
METHODS: This is a prospective consecutive nonrandomized comparative cohort study. Selected patients with axial length > 26.0 millimeters were divided into femtosecond laser capsulotomy (FS) group and manual continuous curvilinear capsulorrhexis (CCC) group. Five experienced phacoemulsification surgeons conducted all surgeries. Intraoperative complications and postoperative anterior segment photography were recorded. Intraocular lens decentration, area of capsulorrhexis, circularity, and capsule overlap were measured at 1 week, 1 month, and 2 years after surgery. Between group differences of parameters were determined with independent-sample t test or the Mann-Whitney U test, analysis of variance test, Pearson chi-square test, and Spearman rank correlation test. 
RESULTS: The study included 142 eyes (108 patients), 68 eyes in the FS group, and 74 eyes in the CCC group. At 1 week, 1 month, and 2 years after surgery, the area of capsulorrhexis in the CCC group was significantly larger than in the FS group (P<0.05), while no significant difference was noted in circularity values. The complete overlap ratio in the FS group was significantly higher than that in the CCC group (P<0.05) at each measured timepoint. Significant correlations were noted between the anterior chamber depth and the area of capsulorrhexis in the CCC group (R=0.25, P = 0.04), but did not correlate in the FS group (P>0.05).  In patients with an anterior chamber depth greater than 3mm, the capsule-intraocular lens (IOL) overlap of the CCC group was less than that of the FS group at all measured timepoints after surgery  (P<0.05). Meanwhile, the IOL decentration in the CCC group was significantly greater than that of the FS group in those patients at 2 years after surgery (P<0.05).
CONCLUSION: In high myopic patients with cataracts, with anterior chamber depth more than 3mm, femtosecond laser capsulotomy can achieve better capsulorrhexis sizing and centering. Due to more precise capsulotomy and a better capsule-IOL overlap in the FS group, femtosecond laser capsulotomy resulted in better long-term centration of the IOL.