EyeWorld India December 2018 Issue

December 2018 22 EWAP FEATURE Experts say the automated system provides benefits beyond the capsulotomy that can vastly improve surgical outcomes T he Zepto capsulotomy system (Mynosys Cel- lular Devices, Fremont, California) entered the U.S. market in June 2017, and since then, surgeons have found the automated capsulotomy device provides numerous clinical ben- efits. By shortening surgery time, providing consistent, circular cap- sulotomies, preserving visual axis information during surgery, and reducing risks of some complica- tions, the Zepto device makes com- plex cases routine and can even extend a seasoned surgeon’s career, according to physicians who use it regularly. The Zepto system consists of a disposable handpiece with a silicone suction cup and a nitinol ring made of a nickel-titanium alloy. The application of suction forces the nitinol ring against the capsule, and a short pulse of energy causes the ring to create a hole in the capsule, creating a circular, centered capsulotomy in 4 milliseconds. Zepto: More than a capsulotomy device by Lauren Lipuma EyeWorld Contributing Writer “It’s a very interesting technol- ogy; there’s more to it than first meets the eye,” said Kevin Waltz, MD, chief medical officer of Myno- sys, Indianapolis. “We can provide a consistent capsulotomy. We can preserve the visual axis informa- tion during surgery. We can likely improve healing after surgery. All of those things add up to it be- ing more than just a capsulotomy device.” “I think it has immense po- tential in terms of being a tool in the toolbox for those challenging cases,” said Russell Swan, MD, Vance Thompson Vision, Boze- man, Montana. “I would encourage people to become familiar with the technology, even if they have ques- tions about the refractive impact of the capsulotomy.” Advantages of Zepto Zepto provides benefits to surgeons over both a manual capsulorhexis and the femtosecond laser in a variety of cases, according to Florian Kretz, MD, chief ex- ecutive officer, Eyeclinics Ahaus- Greven-Raesfeld-Rheine, Germany. He thinks the Zepto system gives him a rounder, more stable cap- sulotomy compared to a manual capsulorhexis. The Zepto handpiece has a collapsible capsulotomy tip whose main component is a low pro le, transparent silicone suction cup that houses a thin-walled nitinol capsulotomy ring. When the Zepto tip is outside of the eye, the push rod is extended to elongate the collapsible tip so that it can t through corneal incisions 2.2 mm and greater. Once in the eye, the push rod needs to be pulled back and its tip left at position 1 to allow the suction cup and capsulotomy ring to regain their circular shape. With the tip at position 1, the push rod can provide mechanical stiffness to Zepto’s silicone neck (ar- row) and assist the surgeon in positioning the capsulotomy tip at the desired location. Source (all): Russell Swan, MD