Capsulorhexis flap dimensions between manual continuous curvilinear capsulorhexis and zepto-assisted capsulotomy: A prospective study

Purpose: The purpose of this study is to compare rhexis flap dimensions between manual continuous curvilinear capsulorhexis (CCC) and zepto-assisted capsulotomy. Methods: A prospective study including consecutive 10 patients of CCC and consecutive 10 patients of zepto capsulotomy. Two methods were used to compare the CCC and zepto capsulotomy flaps. In the first method, digital caliper was used to compare the vertical and horizontal dimensions of the CCC and zepto flaps under microscope. In the second method, New Eyes software was used to measure the rhexis flap dimensions from the postoperative slit-lamp photo. Dilated slit-lamp photograph is captured and capsulorhexis size, shape, continuity, and intraocular lens (IOL) optic coverage was evaluated. Results: The t-test was used for the statistical analysis. The mean difference between the flap dimensions in the two groups is not statistically significant. The coefficient of variation is more in manual than the Zepto method for all the parameters, i.e., DC_VL (10.0% vs. 0.6%); SW_VL (12.5% vs. 0.8%); DC_HL (14.2% vs. 0.3%); and SW_VL (19.0% vs. 0.3%). Discussion: Zepto-assisted capsulotomy is very precise and has a good predictability and repeatability. Complications can be related to technique. Both methods ensure optimal IOL-optic coverage, but the repeatability of rhexis dimensions is more with zepto than CCC.