In early 2016, Dr. Kevin Waltz participated in initial trials of the Zepto capsulotomy system (Mynosys) at Clínica Quesada in San Salvador, El Salvador. The Zepto device was subsequently approved by the FDA in June 2017 based on a successful US-based 510(k) device clinical trial.
When Dr. Waltz went back to El Salvador in late 2017 to follow up on the anterior capsulotomies created 1.5 years before, he found that they had been remarkably stable over time. But even more interesting were the posterior capsules in these eyes. There was little to no PCO at 1.5 years after surgery (Figure 2 in the article). Based on his 20 years of experience performing surgery in Central America, Dr. Waltz found this absence of PCO was a very unusual finding.
Dr. Waltz attributes these findings in part to the strong anterior capsulotomy that the Zepto creates, combined with the flushing mechanism to release the vacuum from the eye after the capsulotomy is created.
Here is the executive summary (the balance of the article is in Italian):
Purpose: to report initial clinical experience with precision pulse capsulotomy (PPC) in cataract surgery and to review the current state of the art in Literature. Methods: Patients were enrolled from those referred to a surgical clinical centre for cataract surgery. The Zepto device was used to perform a PPC through a (less than or equal to) 2.4 mm corneal incision. This was followed by phacoemulsification and intraocular lens (IOL) implantation. Results: 29 eyes were enrolled. All cases resulted in 360-degree complete, round capsulotomies averaging 5.3 mm in diameter with intracapsular IOL insertion. A tendency to inferior decentration was observed. No PPC-related complications were observed. Conclusions: The technical skills and early results of PPC show promising data that could support an increasingly widespread use of this technique, also and especially in cases of cataract with increased risk of complications.
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