System and method of performing femtosecond laser accomodative capsulotomy

A method comprising:

• making a first incision in an anterior capsule of a capsular bag, the first incision being less than or equal to approximately 3.5 mm in diameter;
• making a second incision in the anterior capsule, the second incision being less than or equal to approximately 3.0 mm in diameter, wherein the first incision and the second incision are positioned off-center from a center portion of the anterior capsule;
• performing lens fragmentation of a lens in the capsular bag to yield lens material;
• inserting a first instrument into the first incision;
• inserting a second first instrument into the second incision;
• and
• removing the lens material via one of the first instrument and the second instrument and through one of the first incision and the second incision.

A system comprising:

• a processor;
• a laser;
• and
• a computer readable medium storing instructions, which, when executed by the processor, cause the processor in connection with the laser to perform operations comprising:
• making a first incision in an anterior capsule of a capsular bag, the first incision being approximately equal to or less than 3.5 mm in diameter;
• and
• making a second incision in the anterior capsule, the second incision being approximately equal to or less than 3.5 mm in diameter, wherein the first incision and the second incision are positioned to maintain at least a portion of capsular tensile strength and integrity across the anterior capsule.

A device comprising:

• a neck portion having a tip end and a control end, the neck portion having a first channel for irrigating an eye during a surgery and a second channel for aspirating material from the eye during the surgery;
• a flexible and extendable tip portion connected to the tip end of the neck portion;
• a tip portion control mechanism connected to the flexible and extendable tip and connected to a user control system;
• an irrigation opening positioned generally at the tip portion and connected through the first channel with an irrigation system that causes material to flow through the first channel and through the irrigation opening into the eye;
• an aspiration opening, positioned on the flexible and extendable tip portion, which aspirates lens material from the eye through the second channel to an aspiration system;
• and
• a movable member connected to the user control such that user movement of the movable member causes the control medium to perform one of lateral movement and extension or contraction of the flexible and extendable tip portion from a point beyond an incision entry point in the eye.

A method comprising:

• via an automated, computer-guided system:
• making an incision in an anterior capsule of a capsular bag, the incision being less than approximately 3.5 mm in diameter, wherein at least one of a size, a position, and a shape of the incision are chosen based on feedback associated with a capsular tensile strength across the anterior capsule;
• and
• performing endocapsular lens fragmentation of a lens in the capsular bag to yield lens material.