New research published in the Journal of Cataract & Refractive Surgery indicates the use of Centricity Vision’s precision pulse capsulotomy (PPC) technology is more effective for capsulotomy creation in white cataracts than continuous curvilinear capsulorhexis (CCC; manual capsulorhexis).
Refresh me on white cataracts first.
White cataracts are full of cortical material enveloping a hard nucleus, leading to their characterization as “swollen.” Surgical treatment for the disease is known to have a high rate of complications; one of the major challenges surgeons face for management is the creation of a continuous circular capsulorhexis.
To note, capsulorhexis has been found to be not totally successful in white cataracts management.
Now talk about this PPC technology.
The Zepto Intraocular (IOP) Positioning System is the first and only device that creates an instantaneous capsulotomy with consistent, 360-degree IOL overlap that targets precision and efficiency for optical lens positioning (ideally premium IOLs) in cataract surgery.
How does it work?
The device consists of a handpiece with a capsulotomy tip—made of a suction cup and embedded nitinol capsulotomy ring element—that is folded and inserted into corneal incisions 2.2 mm or greater, then re-expanded to its original shape after entering the eye.
Suction via the suction cup secures the ring against the capsule while simultaneously delivering energy to create the entire perimeter of the capsulotomy.
See here for further details.
How could this treat white cataracts?
According to investigators, this PPC technology has the ability to function amidst poor capsular visibility, takes only 4 milliseconds to create a whole capsulotomy to rapidly release intralenticular pressure, and contains a capsular-edge strength.
Now tell me about this study.
Researchers conducted a retrospective analysis of surgical case records from 35 white cataract surgeries—20 cases using PPC (11 females; 9 intumescent and 11 non-intumescent) and 15 cases using CCC (7 females; 10 intumescent and 5 non-intumescent).
There were no differences found by ethnicity analyzed as groups consisting of White or Caucasian, Black or African American, Asian, and others (P = 0.62, chi-square test).
What else?
Data included relevant medical history, primary and associated diagnosis, date of surgery, and laterality of the operated eye. Comorbidities were noted as well as any relevant medications.
Preop data included uncorrected/corrected distance visual acuity (UCDVA/CDVA), IOP, axial lengths, and anterior chamber depth (ACD)/contralateral ACD. Postoperative data was recorded at 1 day, 1 week, 1 month, and 3 months post-surgery; IOP was recorded at 1 day, 1 week, and 1 month.
Findings?
In comparison to CCC, researchers determined PPC to have significant advantages for white cataract treatment, including:
- IOL implantation with a 360-degree capsular overlap for all 35 cases.
- No need for trypan blue capsular staining and a high molecular, weight-cohesive viscosurgical device (OVD) without evidence of an “Argentinian flag” sign.
- A reduced overall procedural time (approximate average of 1 minute).
- Highly effective in fast decompression and neutralization of potential intralenticular pressure.
- Ability to create complete, consistently–round capsulotomies (without tags/tears).
A complete discussion can be found here.
Final thoughts.
The study authors determined that, based on the data, the PPC technology can be considered to be a highly effective method coupled with a favorable safe profile when creating consistent capsulotomies in patients with white cataracts—making these complex surgeries potentially more routine while cutting down on surgical time.