Capsulotomy triggers prostaglandin release in FLACS

Anterior capsulotomy is the main trigger for an increase of prostaglandins in the aqueous humour that occurs immediately after femtosecond laser-assisted cataract surgery (FLACS), according to researchers from the Institute for Vision Science and the Experimental Eye Research Institute, Ruhr University Eye Hospital, Bochum, Germany.

Reporting in the Journal of Refractive Surgery, the researchers collected the aqueous humour from 67 patients twice: once after the pretreatment for FLACS (only capsulotomy, only fragmentation, or both) and again at the beginning of routine cataract surgery. They then used an enzyme-linked immunoassay to measure total prostaglandin levels in all four groups.

Significantly higher levels of aqueous humour prostaglandins were detected immediately after the procedure in patients who underwent both capsulotomy and fragmentation (330.6 ± 110.6 pg/mL) or only laser capsulotomy 362.4 ± 117.5 pg/mL), compared to the control group (52.5 ± 8.1 pg/mL).

Patients who underwent only FLACS fragmentation did not demonstrate a prostaglandin increase (186.8 ± 114.0 pg/mL).

The researcher concluded that it may be possible to reduce laser-induced miosis by optimizing the laser’s energy settings and using nonsteroidal anti-inflammatory drugs.