Comparison of femtosecond laser capsulotomy versus manual capsulorhexis

Session Details

Session Title: Femto Cataract II

Session Date/Time: Monday 15/09/2014 | 14:30-16:30

Paper Time: 14:54

Venue: Boulevard B

First Author: : S.Chee SINGAPORE

Co Author(s): :                  

Abstract Details

Purpose:

Prospective evaluation of the femtosecond laser-assisted cataract surgery (FLACS) technique for anterior capsulotomy and lens fragmentation compared with the manual capsulorhexis.

Setting:

Singapore National Eye Centre

Methods:

In this single-centre study, 19 eyes underwent a FLACS procedure (Victus, Bausch + Lomb Technolas) and 23 eyes had the standard cataract surgery procedure. A capsulotomy diameter of 5.0mm was targeted in both groups and all eyes received a monofocal IOL. Measured outcomes included uncorrected distance visual acuity (UDVA) and best corrected visual acuity (BCVA), effective phaco time (EPT), intraocular pressure (IOP), corneal swelling, flare, central retinal thickness, capsulotomy diameter and circularity, and IOL overlap and centration.

Results:

Mean patient age was 67±9 years in the FLACS group and 67±8 years in the manual group. Both groups had a similar distribution of cataract grades, ranging from 1 to 5. A statistically significant difference in EPT was observed between the FLACS and manual group (2.40±1.48s vs 3.94±2.42s; p=0.039). Mean change in corneal thickness in the FLACS group at 1 day and 1 week post-op was 17.05±13.83µm and 8.41±10.98 µm compared with 30.22±28.65µm and 17.77±22.29µm in the manual group. At 1 month follow-up, 89.47% of patients had UDVA of 20/40 or better in the FLACS group compared with 82.61% in the manual group. For CDVA, all patients achieved 20/25 in the FLACS group versus 91.30% in the manual group. For an intended diameter of 5.0mm, ex-vivo analysis of the capsulotomy showed an achieved diameter of 5.036±0.082mm in the FLACS group versus 4.838±0.319mm in the manual group (p<0.01). Eccentricity was 0.985±0.006 in the FLACS group compared with 0.949±0.034 in the manual group (p<<0.01), where 1.0 equals a perfect circle. IOP, flare and IOL overlap data were comparable between the two groups.

Conclusions:

Interim results at 1 month follow-up indicate the FLACS technique may provide more rapid improvement in UDVA and CDVA, reduces EPT and improves the accuracy and reproducibility of anterior capsulotomies. Data also indicates FLACS has a potential to reduce post-operative flare. Further analysis is needed to confirm these findings.

Financial Interest:

One or more of the authors... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented