Intrascleral anchoring knot on the double suture without peritomy for fixation of intraocular lens.

A new minimally invasive technique for universal fixation of any posterior chamber intraocular lens (IOL), iris prosthesis or capsular tension device (CTD), both for rescuing in case of dislocation and for secondary implantation, is described. It uses intrascleral anchoring knot on the reinforced double 9-0 polypropylene suture without conjunctival opening or scleral dissection. The technique was applied for scleral fixation of the S-shaped monoblock acrylic IOL dislocated into the vitreous cavity in 1 eye, and decentered IOL-CTD-capsular bag complexes in 3 eyes. In none of the cases, complications including knot slippage, suture exposure or hypotony were observed. All patients were followed up for 6 months. The uncorrected distance visual acuity was significantly improved and the IOLs positions remained stable. The described technique might be a simple, effective and safe alternative to flanged scleral fixation approaches.

Experimental femtosecond laser-assisted nanosurgery of anterior lens capsule.

PURPOSE: To investigate femtosecond laser-assisted nanosurgery of the anterior lens capsule in a prospective in vitro study. METHODS: Eight anterior lens capsules obtained during conventional phaco surgery were irradiated with a nonamplified 80-MHz near-infrared 800-nm titanium:sapphire femtosecond laser. Line intratissue laser cuts were examined by femtosecond multiphoton laser scanning microscopy (MLSM) and transmission electron microscopy (TEM). RESULTS: Speed parameters of the laser beam, laser ablation time, and pulse power determined the width of the lesions, which ranged from 220±40 nm (SD) to 1.49±0.15 µm. Both MLSM and TEM revealed minimal collateral alterations in the tissue surrounding the laser cuts. CONCLUSIONS: Nonamplified near-infrared femtosecond laser pulses at low pulse energies may be a promising strategy for precise noncontact nanosurgery of the anterior lens capsule with minimal collateral damage to surrounding tissue. High-resolution MLSM offers 3-dimensional, noninvasive, nondestructive imaging at submicrometer resolution within seconds before and after ablation.

In vitro femtosecond laser-assisted nanosurgery of porcine posterior capsule.

PURPOSE: To investigate femtosecond laser-assisted nanosurgery of the posterior capsule in a prospective in vitro animal study. SETTING: Department of Ophthalmology and Eye Hospital, University of Saarland, Homburg, and Fraunhofer Institute for Biomedical Engineering, St. Ingbert, Germany. METHODS: The posterior capsules of 12 porcine eyes were irradiated with a nonamplified 90 MHz near-infrared 750 nm titanium:sapphire femtosecond laser. Intratissue and superficial laser cuts of laser-ablated (5 capsules) and control (1 capsule) specimens were examined by femtosecond multiphoton laser scanning microscopy (MLSM) and transmission electron microscopy (TEM). RESULTS: Laser exposure time and pulse power determined the width of the lesions, which ranged from 0.69 microm+/-0.19 (SD) to 2.81+/-0.5 microm. Both MLSM and TEM revealed minimal collateral alterations in the tissue surrounding the laser cuts. CONCLUSIONS: Nonamplified near-infrared femtosecond laser pulses at low pulse energies may be a promising strategy for precise lamellar noncontact nanosurgery of the posterior capsule, with minimal structural collateral damage to surrounding tissue. High-resolution MLSM offers 3-dimensional, noninvasive, nondestructive imaging at submicrometer resolution within seconds before and after ablation.