EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
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EW FEATURE 62 Products that could change how you practice • September 2018 Experts say the automated system provides benefits beyond the capsulotomy that can vastly improve surgical outcomes by Lauren Lipuma EyeWorld Contributing Writer Zepto: more than a capsulotomy device since then, surgeons have found the automated capsulotomy device pro- vides numerous clinical benefits. By shortening surgery time, providing consistent, circular capsulotomies, preserving visual axis information during surgery, and reducing risks of some complications, the Zepto device makes complex cases routine and can even extend a seasoned surgeon's career, according to physi- cians 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 appli- cation 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. "It's a very interesting tech- nology; 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 being 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 va- riety of cases, according to Florian Kretz, MD, chief executive officer, Eyeclinics Ahaus-Greven-Raesfeld- Rheine, Germany. He thinks the Zepto system gives him a rounder, more stable capsulotomy compared to a manual capsulorhexis. "Zepto has become a major part of my procedures," Dr. Kretz said. "It is the premium procedure for patients not able to afford FLACS [femtosecond laser-assisted cataract surgery]." T he Zepto capsulotomy system (Mynosys Cellular Devices, Fremont, Cali- fornia) entered the U.S. market in June 2017, and