Efficacy and safety of aselective laser device to create centred capsulotomies in white intumescent cataracts: international multicentre study (LC-WIC study)

PURPOSE: To evaluate the efficacy and safety of a selective laser device (CAPSULaser, EXCEL- LENS, CA, USA) to create centred and circular anterior capsulotomies in eyes with white intumescent cataracts. SETTING: International, multicentre, study across five clinical sites in the United Kingdom, Bulgaria, India and Saudi Arabia. DESIGN: Prospective, multicentre interventional cohort study. METHOD: A total of 93 eyes of 91 subjects with white intumescent cataracts were recruited after anterior segment OCT (AS-OCT) established the presence of intralenticular fluid pockets indicative of raised intralenticular pressure. In all cases, prior to phacoemulsification, selective laser capsulotomy (SLC) was performed by staining the anterior capsule with a customised 0.4 % trypan blue solution. Capsulotomies were created with a diameter of 5.5 mm. Subjects were followed up at one day, one week, one and three months postoperatively. RESULTS: In all cases, the capsulotomy was successfully created. No intraoperative complications were observed. At 3 months postoperatively the mean capsulotomy diameter measured 5.3 mm (range: 5.2 to 5.5 mm). No cases of capsular phimosis were observed during the three months follow-up. In all cases, visual acuity improved from preoperative light perception to mean postoperative uncorrected distance visual acuity (UDVA) of 0.28 LogMAR (range: 0.0 to 1.0). CONCLUSION: The use of SLC in this series of eyes with intumescent cataracts achieved consistently sized and well-centred capsular openings. There were no complications. These results highlight the precision and safety of using selective laser capsulotomy for creating anterior capsulotomies in white intumescent cataracts.