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.