Calculation of ophthalmic viscoelastic device–induced focus shift during femtosecond laser–assisted cataract surgery

Carolina P. De Freitas, Florence Cabot, Fabrice Manns, William Culbertson, Sonia H. Yoo, Jean Marie Parel

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


PURPOSE. To assess if a change in refractive index of the anterior chamber during femtosecond laser-assisted cataract surgery can affect the laser beam focus position. METHODS. The index of refraction and chromatic dispersion of six ophthalmic viscoelastic devices (OVDs) was measured with an Abbe refractometer. Using the Gullstrand eye model, the index values were used to predict the error in the depth of a femtosecond laser cut when the anterior chamber is filled with OVD. Two sources of error produced by the change in refractive index were evaluated: the error in anterior capsule position measured with optical coherence tomography biometry and the shift in femtosecond laser beam focus depth. RESULTS. The refractive indices of the OVDs measured ranged from 1.335 to 1.341 in the visible light (at 587 nm). The error in depth measurement of the refilled anterior chamber ranged from -5 to þ7 lm. The OVD produced a shift of the femtosecond laser focus ranging from -1 to þ6 lm. Replacement of the aqueous humor with OVDs with the densest compound produced a predicted error in cut depth of 13 lm anterior to the expected cut. CONCLUSIONS. Our calculations show that the change in refractive index due to anterior chamber refilling does not sufficiently shift the laser beam focus position to cause the incomplete capsulotomies reported during femtosecond laser–assisted cataract surgery

Original languageEnglish (US)
Pages (from-to)1222-1227
Number of pages6
JournalInvestigative Ophthalmology and Visual Science
Issue number2
StatePublished - 2015


  • Capsulotomy
  • Cataract surgery
  • Femtosecond laser
  • Ophthalmic viscoelastic device
  • Optical coherence tomography

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience


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