Purpose: The Pulsed Electron Avalanche Knife (PEAK-fc) is a new pulsed electrosurgical device which allows for precise, "cold" and traction-free tissue dissection. This study was performed to evaluate surgical applicability, safety and potential complications of PEAK-fc in complicated cataract surgery.
Methods: The study included five children with congenital cataracts, two patients with advanced senile cataracts, six adult patients with mature cataracts, three of them with posterior iris synechia, three posttraumatic cataracts with zonulolysis, one intumescent traumatic cataract and three patients with massive anterior capsule opacification. Anterior and posterior capsulotomies, iris synechiolysis, dissection of anterior capsule opacification and fibrotic scar tissue have been performed. PEAK-fc was set at voltages of 500 to 700V, pulse duration of 0.1 ms, and repetition rate of 40 to 100Hz.
Results: Anterior and posterior capsulotomies were successfully and safely performed in all eyes. The edges of capsulotomies appeared sharp, showing only limited collateral damage. PEAK-fc worked best by just gently touching the capsule, thereby avoiding tractional forces or pressure on the lens capsule. Posterior iris synechiae could be released and anterior capsule opacification was dissected without complications.
Conclusions: PEAK-fc is a very helpful cutting device for complicated cases of cataract surgery, especially for mature and congenital cataracts, traumatic zonulolysis or anterior segment complications following intraocular inflammation.
- cataract surgery