Surgical Technique
One experienced surgeon (R.S.) performed all the surgeries. Capsulotomy,
corneal incisions and lens fragmentation were accomplished by
femtosecond laser (LDV Z8, Ziemer, Switzerland), followed by
emulsification, irrigation and aspiration of lens material performed
with the phacoemulsification machine (Centurion Vision, Alcon
Laboratories, USA).
Capsulotomy was centered on the pupil center (PC) or the first Purkinje
reflex (FPR), according to the protocol’s randomized assignment. For
this matter, in the FPR group of patients, the coaxially sighted
subject-fixated corneal light reflex (CSFCLR) was marked on the cornea
surface with an ink marker, immediately before femtosecond docking, and
capsulotomy was centered on this point. In the PC group, pupil
centration was achieved automatically with LDV OCT imaging upon docking
and capsulotomy performed henceforth (Figure 2A and B).