METHOD OF SELECTING PARAMETERS FOR ANTERIOR FEMTOLASER CAPSULOTOMY IN OVERMATURE SWELLING CATARACT Russian patent published in 2023 - IPC A61F9/08 

FIELD: medicine; ophthalmology.

SUBSTANCE: using intraoperative optical coherence tomography (iOCT), the type of overripe swelling cataract is determined and the structural state of the anterior lens capsule is assessed. Prior to the femtolaser support of cataract surgery, the anterior lens capsule is stained with trypan blue, viscoelastic is injected into the anterior chamber, and the parameters of femtolaser exposure are adjusted depending on the condition of the anterior lens capsule, namely: in case of anterior capsule thinning — 60% of the femtolaser energy, in the presence of hyperreflective cortical masses — 80% of the energy of the femtolaser, in case of fibrous changes in the anterior capsule — 100% of the energy of the femtolaser. The height of the femtolaser cut of the anterior capsule is set depending on the type of overmature cataract according to iOCT data: for type 2 — 800 mcm, for type 3 — 1,000 mcm, for type 4 — 1,100 mcm; then, docking and anterior femtocapsulotomy are performed, after which the released cortical masses and vapor-gas bubbles are aspirated from the anterior chamber. Next, iOCT is performed and the quality of the resulting anterior femtocapsulotomy is assessed with determining the free edge of the anterior capsule disc cut by the femtolaser and the area of non-cutting. Then the free edge of the disc is captured and the carved disc is isolated from the anterior capsule in a circular motion along the femtolaser cut; the disc of the anterior capsule isolated along the entire circumference is removed.

EFFECT: reduction of the tension of the anterior lens capsule, stabilizing the position of the anterior capsule during the femtolaser stage, reduction of the uncontrolled exit of lysed masses into the anterior chamber, accurate determination of the free edge of the anterior capsule disc cut by the femtolaser, obtaining a continuous circular centrally located anterior capsulorhexis, elimination of the risk of radialization and rupture lens capsules during overmature swelling cataract surgery.

1 cl, 3 ex