Lasers in Cataract Surgery

September 20, 2018 — by William Goldstein
Tags: Laser Cataract Surgery Cataract Surgery Cataracts Phakoemulsification

During laser cataract surgery, the damaged, natural lens of the eye is removed while the posterior
portion of the lens capsule holding the natural lens is retained in order to hold the intraocular lens
or IOL implant. In many cases, the capsule tends to become partly opaque which can affect the
visual acuity in patients who have undergone a cataract surgery. This condition is called posterior
capsule opacification or PCO. The opacification prevenst light from reaching the retina.
In order to treat PCO, surgeons make an incision in the capsule to allow light to enter. This
process is called capsulotomy.
During cataract surgery, the front of the capsule needs to be opened to allow access to the cataract. When a capsulotomy is performed, the quality of the outcome lies in the shape and accuracy of
the incision. In order to achieve this, scientists and researchers have developed the Zepto
Precision Pulse Capsulotomy device. The other options are to perform this step by hand, or with a femto laser if laser cataract surgery is desired.

What is the Zepto Capsulotomy system?


The Zepto Capsulotomy system is essentially a handheld device that is used to make precise,
circular incisions on the capsular surface. The system is disposable and improves the outcomes
of a capsulotomy.
The main component of the Zepto Capsulotomy device is the instrument’s tip. The tip is made of
a material called nitinol, an alloy of titanium and nickel. The nitinol alloy has a shape memory
feature, which means that it can retain its original shape even after subjecting it to a force that
can change its shape.
The nitinol tip is shaped in the form of a circular ring. The edges of this ring are engineered
precisely on a micron scale.
During laser cataract surgery, an incision is made on the cornea through which the tip is inserted into the
eye. The nitinol ring is first compressed and elongated for ease of insertion. Once the tip has
reached the capsule, the force compressing the tip is released, and being a shape memory alloy,
the tip retains the original circular shape. Once the tip makes contact with the lens capsule,
pulses are delivered to the ring which creates a perfect circular incision on the capsule without
any need for cauterization. The capsulotomy is instantaneous and efficient.
A number of surgeons now use this technique because of the uninterrupted surgical workflow
efficiency it offers. Many surgeons believe that if the Zepto Capsulotomy would be stronger with
a higher tear resistance as compared to other surgical techniques, it would be a huge bonus for
cataract surgeries everywhere.