Primary posterior capsulotomy in femtosecond laser-assisted cataract surgery: In vivo spectral-domain optical coherence tomography study.

PURPOSE: To evaluate whether the size of Berger space is safely predictable in patients having cataract surgery using 3-dimensional spectral-domain optical coherence tomographic (3-D SD-OCT) image analysis.

SETTING: Ruhr University Eye Hospital, Bochum, Germany.

DESIGN: Prospective interventional case series.

METHODS: Eyes having routine femtosecond laser-assisted cataract surgery were included. After wound closure, the anterior eye segment was visualized using the incorporated 3-D SD-OCT. Visualization of Berger space was performed in the axial and sagittal planes.

RESULTS: The study comprised 165 consecutive eyes. In 155 eyes, 3-D SD-OCT visualized Berger space and its dimensions were analyzed. In 72% of the cases, Berger space was large enough to perform a femtosecond laser-assisted primary posterior capsulotomy. In 24 eyes (15.5%) with a minimum axial length of 25.0 mm, Berger space was 500 μm or larger.

CONCLUSION: Femtosecond laser systems incorporating real-time SD-OCT allowed direct visualization of Berger space intraoperatively, providing surgeons with the information needed to safely create posterior capsulotomies after intraocular lens implantation.

FINANCIAL DISCLOSURE: Dr. Dick is a consultant to Abbott Medical Optics, Inc. No other author has a financial or proprietary interest in any material or method mentioned.