Use of the 590-nm CAPSULaser in true open-sky penetrating keratoplasty triple procedures: a technical report of two cases.
Saleh Algamdi, Sami Hameed, Raed Alsulami et al.
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Case in brief
Two eyes with advanced corneal opacity and visually significant cataract underwent combined penetrating keratoplasty, cataract extraction, and intraocular lens implantation. After removal of the host corneal button, the surgeons stained the anterior capsule with trypan blue and used a microscope-mounted 590-nm CAPSULaser to create a targeted 5.5-mm capsulotomy under true open-sky conditions. Both eyes had a continuous 360-degree opening, without reported radial extension or vitreous loss. Lens extraction and in-the-bag lens placement were completed; at six months, both grafts were clear and the lenses centered.
What made this case unusual
The laser capsulotomy was performed after removal of the host cornea, when the eye was in a true open-sky state during a penetrating keratoplasty triple procedure.
Diagnostic / clinical pearl
A microscope-mounted 590-nm CAPSULaser can create an anterior capsulotomy in true open-sky conditions, but this two-case report establishes technical feasibility only, not comparative safety or efficacy.