Fig 12.—The Fugo Blade™ may be used to enlarge the capsulotomy size. Top left: A radial incision was just placed at the 11-o’clock position along the capsulotomy, and is now
about to be placed at the 10-o’clock position. Top right: Radial capsulotomy incisions were placed at 10 o’clock and 11 o’clock, and now is about to be placed at the 8-o’clock
position. Lower left: Radial capsulotomy incisions were placed at the 6, 7, 8, 10, and 11-o’clock positions. We are about to place another radial capsule incision at the 12-o’clock
position. Lower right: Following radial capsule incisions, viscoelastic solution is infused into the anterior chamber, pushing the small capsule flaps outward. Notice that the cap-
sulotomy margin is now just inside of the pupil margin. Inside of the capsule margin, there are radial incisions in the cortex where the radial capsulotomy incisions were made.
pulling a larger nucleus through a smaller capsuloto-
my opening with the Fugo Blade™ capsulotomy rim.
Finally, it should be emphasized that being able to
perform an anterior capsulotomy without a red reflex
will present the surgeon with a great ability to control
difficult surgeries (Fig 13).
coelastic solution or a red reflex is not needed with
this device. It is advised, however, that the novice sur-
geon employ viscoelastic for maximum safety in sta-
bilizing the anterior chamber during the early
learning curve. In general, surgeons should feel com-
fortable with this unit after about 10 to 20 cases.
Although this unit greatly decreases the difficulty of
opening the capsule as well as enlarging the size of the
capsulotomy, it provides a capsulotomy opening
which is not as strong as that of capsulorhexis. There-
fore, treating this margin in a manner similar to a cap-
sulorhexis is not appropriate. It is much wiser to
enlarge the capsulotomy than to attempt to pull a larg-
er nucleus through a smaller capsulotomy opening
since this will most likely result in a tear of the capsu-
lar rim. It is thereby obvious that surgeons must retool
their mental approach toward cataract surgery when
employing the Fugo Blade™ capsulotomy unit. As
such, the authors suggest using less physical force in
removing cortex and nucleus while employing more
surgical finesse in removing cortex and nucleus
through capsulotomies created with the Fugo Blade™.
Conclusion
In conclusion, the Fugo Blade™ capsulotomy unit
employs a solid-state electronic system powered by
rechargeable batteries to provide maximum patient
safety. It allows the surgeon to perform anterior cap-
sulotomy in a safe and repeatable fashion in seconds.
It also allows the surgeon to easily and safely enlarge
the size of the capsulotomy. Should a surgeon inad-
vertently tear the capsule during the procedure, this
can be repaired by placing a Fugo Blade™ incision in
front of the dissecting head of the tear. Use of the unit
to perform multi-mini-sphincteroromies for small
pupils or iridotomies would be considered an off-label
use. As with phacoemulsification devices, the active
incising tip is a disposable, one-time use item. Vis-
ANN OPHTHALMOL. 2001;33(1)
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