Comparison of the anterior capsulotomy edge created by manual capsulorhexis and 2 femtosecond laser platforms: Scanning electron microscopy study

PURPOSE: To compare the scanning electron microscopy (SEM) features of the anterior capsule edge created by continuous curvilinear capsulorhexis (CCC) and femtosecond laser-assisted capsulotomy using angular second moment and contrast. SETTING: King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia. DESIGN: Prospective comparative series. METHODS: Anterior capsule specimens following CCC (n = 10) or femtosecond laser-assisted capsulotomy using 2 platforms (Lensx, n = 9, and Victus, n = 10) were studied by SEM. Irregularity of the capsule edge was quantified using 2 parameters (angular second moment and contrast) using ImageJ software. The clinical features and laser parameters were correlated with angular second moment and contrast. RESULTS: By SEM, the femtosecond laser-assisted capsulotomy edge surfaces created by both lasers showed marked irregularity compared with the smooth edge of the CCC. The angular second moment and contrast measures for both lasers differed significantly from those obtained for CCC (P<.001). There was no between-laser difference in angular second moment and contrast measures. The angular second moment showed only a weak negative correlation with increasing laser power, whereas contrast showed a weak positive correlation with increasing power. CONCLUSIONS: Both laser platforms created an irregular capsulotonny edge. The angular second moment and contrast quantified capsule edge irregularities for further comparisons. These measures could be used to quantify efforts to reduce capsule-edge irregularity from femtosecond laser-lens capsule interaction.