Capsulotomy is a type of eye surgery in which an incision is made into the capsule of the crystalline lens of the eye. In cataract surgery, the lens capsule is usually retained and used to contain and position the intraocular lens implant (IOL).
There are two type of capsulotomy depending on the areas of the lens capsule that is being incised: anterior capsulotomy and posterior 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.
- Can opener capsulotomy: This 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 to make an incision in the anterior lens capsule.
- 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.
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.
Capsulotomy Risks and Complications
As with any surgery, there are possible risks and complications with capsulotomy. Here are some of them:
- Retinal detachment: This is a condition where the retina pulls away from supportive tissue. You should call your ophthalmologist immediately if this happens to your vision.
- Ocular hypertension: This refers to increase in pressure the eyes.
- IOL dislocation: The intraocular lens implant (IOL) might move through the posterior capsule opening.
- Swelling: There may be swelling in the eye and steroid eye drops may help with the complication.
The total cost for capsulotomy surgery depends on a lot of factors such as the anesthetic fee, private hospital fee, private operating facility fee, extent of surgery required. The total cost of the procedure is around $500 – $1500.