Prostaglandin release during femtosecond laser-assisted cataract surgery: main inducer

Purpose: To investigate a possible correlation between intraocular prostaglandin concentrations and partial steps of laser-assisted cataract surgery.

Methods: Aqueous humor was collected from 67 patients after laser-assisted cataract surgery pretreatment (only capsulotomy, only fragmentation, or both) and at the beginning of routine cataract surgery. Total prostaglandin levels were measured in all four groups using an enzyme-linked immunoassay.

Results: Significantly higher levels of aqueous humor prostaglandins were detected right after the full treatment (capsulotomy and fragmentation [330.6 ± 110.6 pg/mL; P = .01] or only laser capsulotomy [362.4 ± 117.5 pg/mL; P = .01]), whereas the control group showed lower values (52.5 ± 8.1 pg/mL). By itself, laser-assisted cataract surgery fragmentation did not lead to a prostaglandin increase (186.8 ± 114.0 pg/mL; P = .14).

Conclusions: This study identified the anterior capsulotomy as the main trigger for an increase of prostaglandins in the aqueous humor immediately after laser-assisted cataract surgery. Optimized energy settings in combination with nonsteroidal anti-inflammatory drugs might help reduce the phenomenon of laser-induced miosis.