The laser (LenSx platform, Alcon Surgical Inc) was used to perform the capsulotomy, lens fragmentation and wound construction. The pupil centered capsulotomy was used with the following parameters: 4.9mm diameter, with delta up 270 µm, delta down 330 µm, spot energy 6.50 µJ, spot separation 4µm and layer separation 4µm. Traditional phacoemulsification was then used to remove the nucleus.
Lensx platform
Manufactured by Alcon
Sourced in United States
The LenSx platform is a laser-based system designed for ophthalmic surgical procedures. It is used to perform precise corneal and lens incisions during cataract and refractive surgery.
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Lab products found in correlation
7 protocols using lensx platform
1
Laser-Assisted Cataract Surgery
2
Femtosecond Laser-Assisted Cataract Surgery
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All operations were performed by a single experienced surgeon (T.K.), under topical anesthesia (proparacaine hydrochloride 0.5%). For FLACS, the LenSx platform (Alcon Laboratories, Inc., Fort Worth, TX, USA) was used to perform capsulorhexis and nucleus fragmentation. In eyes with astigmatism greater than 0.75 D, femtosecond laser-assisted arcuate keratotomy was performed based on the measurements of corneal astigmatism axis using the Verion corneal topography system (Alcon Laboratories, Inc.). The penetrating keratotomy incision was set at a corneal thickness depth of 80% and an arc diameter of 9.0 mm. A laser corneal incision was created at temporal, and corneal incision sites were carefully dissected using a Sinskey hook and the incised anterior capsule button was removed using forceps. The Centurion Vision System (Alcon Laboratories, Inc.) was used for conventional phacoemulsification, irrigation and aspiration, and polishing. The Eyhance IOL was implanted in the capsular bag; all incisions were closed with stromal hydration. A postoperative topical therapy of levofloxacin 1.5% eye drops, fluorometholone 0.1% eye drops, along with bromfenac sodium hydrate eye drops were instilled four times per day for 1 month.
3
Femtosecond Laser-Assisted Cataract Surgery
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All surgical procedures were performed using femtosecond laser-assisted cataract surgery on the LenSx platform (Alcon Laboratories, Inc., Fort Worth, TX, USA) with a 5.0-mm capsulotomy and chop-and-cylinder fragmentation pattern. Emulsification and aspiration of the fragmented lens and aspiration of the cortex were performed using the Centurion® Vision System (Alcon Laboratories, Inc., Fort Worth, TX, USA). In all cases, the IOLs were inserted in the bag.
4
Femtosecond Laser Capsulotomy Techniques
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This open-label, prospective, comparative cohort study was performed at a private eye clinic between January 2020 and December 2022. The Yokosuka Chuoh Eye Clinic Ethical Committee (reference no. 2022-004) approved the research protocol, and the data collection process adhered to the tenets of the Declaration of Helsinki of 1964. Written informed consent was obtained from all patients after providing a detailed explanation of the procedure and its possible outcomes.
A femtosecond laser platform (LenSx platform, Alcon Laboratories, Inc., Fort Worth, TX, USA) was used to compare the incidences of incomplete capsulotomy, anterior capsule tags and tears, and posterior capsule tears between the conventional and modified capsulotomy techniques.
This study included patients with binocular cataracts, no history of ocular trauma and surgery, no corneal scarring and dystrophy, no ocular disease other than cataracts, no signs of zonular weakness, and no docking failure or eye movement encountered during femtosecond laser treatment. Patients with pupil diameter < 6 mm after the usage of mydriatics, mature cataracts, and significant subcapsular opacity (calcification) were excluded from the study. Capsulotomy was created by using the modified technique in one eye (Group 1, 220 eyes) and the conventional technique in the other eye (Group 2, 220 eyes).
A femtosecond laser platform (LenSx platform, Alcon Laboratories, Inc., Fort Worth, TX, USA) was used to compare the incidences of incomplete capsulotomy, anterior capsule tags and tears, and posterior capsule tears between the conventional and modified capsulotomy techniques.
This study included patients with binocular cataracts, no history of ocular trauma and surgery, no corneal scarring and dystrophy, no ocular disease other than cataracts, no signs of zonular weakness, and no docking failure or eye movement encountered during femtosecond laser treatment. Patients with pupil diameter < 6 mm after the usage of mydriatics, mature cataracts, and significant subcapsular opacity (calcification) were excluded from the study. Capsulotomy was created by using the modified technique in one eye (Group 1, 220 eyes) and the conventional technique in the other eye (Group 2, 220 eyes).
5
Femtosecond Laser-Assisted Cataract Surgery
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To maintain surgical consistency, femtosecond laser (FL) assisted cataract surgery (FLACS) was performed in all eyes using the LenSx platform (Alcon Laboratories, Inc.). The FL was used to undertake capsulotomy, lens fragmentation and astigmatic keratotomies. Strict criteria for suitability for FLACS was followed so that no recruited patients would be excluded from the trial (table 1). Astigmatic keratotomies were performed on patients with corneal astigmatism greater than 0.8 diopters (D) based on corneal topography. All operations were performed under a local anaesthetic (LA) unless clinically indicated otherwise. All outcomes' analysis was undertaken only on the first operated eye, except for PROMS data which was collected on bilateral cases. No other additional procedures were planned, other than the FL astigmatic keratotomies. Phacoemulsification was performed in all eyes using an activefluidics torsional phacoemulsification system (Centurion, Alcon Laboratories, Inc.). The IOL used for in-the-bag placement was randomized to either Clareon® (Alcon Laboratories, Inc.) or Tecnis® PCB00 (Johnson & Johnson Inc.). Operations were performed by six surgeons who had completed at least 30 FLACS procedures (NS, EA, DPSO, VW, MB, SR) before study commencement.
6
Femtosecond Laser-Assisted Cataract Surgery
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Femtosecond laser-assisted cataract surgery (FLACS) was performed using the LenSx platform (Alcon, Fort Worth, TX, USA) to create a 5mm anterior capsulotomy and fragmentation of the nucleus. The main incision and paracentesis were created manually. All phacoemulsification was performed with the Centurion vision system (Alcon, Fort Worth, TX) using topical anesthesia. Optiwave refractive analysis (ORA, Alcon Fort Worth, TX) was used after cataract extraction to verify or modify pre-operative IOL selection. A soft polymer irrigation/aspiration tip was used to polish the posterior capsule. Cataract extraction was uncomplicated and completed in all patients with the placement of a trifocal TFAT00 vs TFAT30-60 IOL.
Visual acuity was measured using the Snellen chart, and the total number of letters read was recorded and converted to logMAR for analyses. Distance measurements for binocular and monocular uncorrected distance visual acuity (UDVA) were tested at 6.1 m under 100% contrast photopic conditions with ambient room lighting. All binocular and monocular uncorrected near visual acuity (UNVA) were tested between 40cm and 33cm at the patient’s comfortable reading distance with photopic conditions with a Rosenbaum near chart with ambient room lighting.
Visual acuity was measured using the Snellen chart, and the total number of letters read was recorded and converted to logMAR for analyses. Distance measurements for binocular and monocular uncorrected distance visual acuity (UDVA) were tested at 6.1 m under 100% contrast photopic conditions with ambient room lighting. All binocular and monocular uncorrected near visual acuity (UNVA) were tested between 40cm and 33cm at the patient’s comfortable reading distance with photopic conditions with a Rosenbaum near chart with ambient room lighting.
7
Femtosecond Laser-Assisted Cataract Surgery
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All patients underwent scheduled cataract surgery, which was performed by a single, experienced surgeon (I.J.). Femtosecond laser-assisted cataract surgery was performed using the LenSx platform (Alcon Laboratories, Inc., Fort Worth, TX, USA) for capsulorhexis, nucleus fragmentation, and penetrating arcuate keratotomy. The keratotomies were centered on the steep corneal axis, and the length of the arcuate keratotomy was determined using a Verion system (Alcon Laboratories, Inc.). After all pattern selections and parameter choices were made, patients were instructed to lie on a built-in bed beneath the laser device. The disposable vacuum interface was positioned to the operation eye with a suction ring, and laser emission was initiated, following which the patient was transported to the operation room. At the start of cataract surgery, laser corneal incision sites were carefully dissected using a Sinskey hook. The incised anterior capsule button was removed using forceps. Patients underwent conventional phacoemulsification using a Centurion Vision System (Alcon Laboratories, Inc.). Following phacoemulsification, a single type of IOL, Artis PL E, was implanted in the capsular bag using an injector, and the remaining ophthalmic visco-surgical device was removed. All incision sites were hydrated to prevent leakage.
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