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Capsulotomy (BrE /kæpsjuː'lɒtəmi/, AmE /kæpsuː'lɑːtəmi/) is a type of eye surgery in which an incision is made into the capsule of the crystalline lens of the eye. In modern
cataract A cataract is a cloudy area in the lens of the eye that leads to a decrease in vision. Cataracts often develop slowly and can affect one or both eyes. Symptoms may include faded colors, blurry or double vision, halos around light, trouble w ...
operations, the lens capsule is usually not removed. The most common forms of
cataract surgery Cataract surgery, also called lens replacement surgery, is the removal of the natural lens of the eye (also called "crystalline lens") that has developed an opacification, which is referred to as a cataract, and its replacement with an intraocul ...
remove nearly all of the crystalline lens but do not remove the crystalline lens capsule (the outer "bag" layer of the crystalline lens). The crystalline lens capsule is retained and used to contain and position the intraocular lens implant (IOL). Before the advent of laser surgery, a tiny knife called a cystotome was used to cut a hole in the center of the lens capsule, thus providing a clear path for light to reach the retina. This procedure thus reduces the opacity of the lens of the eye.


Anterior capsulotomy

The removal of anterior lens capsule during cataract surgery is known as anterior capsulotomy. It is one of the most important steps in cataract surgery.


Types


Can opener capsulotomy

Can opener capsulotomy is done by making a circular opening of 5–6 mm diameter in the anterior capsule, by series of small tears with a cystitome. Jacques Daviel invented this technique in 1752. This technique is commonly done during extracapsular cataract extraction.


Envelope capsulotomy

Envelope capsulotomy is done by making a linear incision in upper one-third of anterior capsule. Sourdilla and Baikuff suggested this technique in 1979.


Femtosecond laser-assisted capsulotomy

This technique uses
femtosecond laser Mode locking is a technique in optics by which a laser can be made to produce pulses of light of extremely short duration, on the order of picoseconds (10−12 s) or femtoseconds (10−15 s). A laser operated in this way is sometimes r ...
to do capsulotomy.


Plasma blade capsulotomy

Plasma blade capsulotomy uses plasma technology to create an incision in anterior capsule.


Precision Pulse Capsulotomy/Zepto

Precision Pulse Capsulotomy is a non laser capsulotomy procedure performed using a device with a soft collapsible tip and circular Nitinol cutting element that is connected to a control console.


Posterior capsulotomy

Months or years after the cataract operation, the remaining posterior lens capsule can become opaque and vision will be reduced in about 20–25% of eyes. This is known as posterior capsule opacification (PCO). PCO is best treated by posterior capsulotomy using
YAG laser YAG laser may refer to two types of lasers that use yttrium aluminum garnet (YAG): * Nd:YAG laser (doped with neodymium) * Er:YAG laser (doped with erbium) {{disambig ...
.


Complications

Retinal detachment, Ocular hypertension and
IOL Cherchell (Arabic: شرشال) is a town on Algeria's Mediterranean coast, west of Algiers. It is the seat of Cherchell District in Tipaza Province. Under the names Iol and Caesarea, it was formerly a Roman colony and the capital of the ki ...
dislocation are the major complications of posterior capsulotomy.


References


Further reading

* {{Eye surgery Eye surgery