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Analysis of lens position and functional outcomes: femtosecond laser-assisted cataract surgery (FLACS) vs conventional micro incision cataract surgery (MICS)

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Session Details

Session Title: Femtolaser-Assisted Cataract Surgery (FLACS) I

Session Date/Time: Sunday 08/10/2017 | 08:00-10:00

Paper Time: 09:14

Venue: Room 3.6

First Author: : G.Ahuja INDIA

Co Author(s): :    N. Shroff   R. Dutta   A. Koul   K. Priya           

Abstract Details


To compare the effective lens position, visual outcomes and surgical efficiency in Femtosecond Laser Assisted Cataract Surgery (FLACS) and conventional Micro Incision Cataract Surgery.


Cataract & Intraocular Lens Implantation Service, Shroff Eye Centre, A-9 Kailash Colony, New Delhi, India 110048.


70 eyes underwent cataract extraction (35 each in FLACS and MICS groups). All eyes underwent phacoemulsification by the Centurion Vision System by the same surgeon. Intra-operative parameters evaluated were CDE and volume of fluid used. Post-operative parameters were UCVA, BCVA, refractive spherical equivalent (SEQ), CCT and endothelial cell count. The achieved ELP (IOLMaster700) was compared with the predicted ELP (Holladay1 Formula). IOL tilt was assessed by measuring coma (iTrace Ray tracing aberrometry). Dilated slit-lamp photographs were analyzed for IOL and CCC centration and size using Meazure 2.0 software.


Mean CDE was 7.23±3.52 (FLACS) and 13.08±5.36 (MICS)(p=.012). Mean fluid volume was 82.11±30.1 (FLACS) and 79.50±27.8 (MICS)(p=.183). Day-1 UCVA was 0.13±0.17(FLACS) and 0.19±0.22(MICS) and was comparable at day-7 and day-30. SEQ in diopters at 1-month was -0.15±0.26 (FLACS) and -0.20±0.39 (MICS)(p=.646). Endothelial cell loss was 9.74±16.5%(FLACS) versus 17.03±18.0%(MICS). The difference between the achieved and predicted ELP was comparable (FLACS 0.51±0.24mm, MICS 0.53±0.32mm). Coma was comparable in both groups. Mean CCC-size and coefficient-of-variation was 4.96±0.21mm;4.15%(FLACS) and 4.94±0.39;8.02%(MICS). The IOL centration with respect to the CCC and limbus, and that of CCC to the limbus were comparable in both groups.


FLACS definitely reduces the energy required for emulsifying the nucleus resulting in clearer corneas and better UCVA on day 1 with lesser endothelial cell loss. However, the perfectly circular well-centered CCC with its consistent size does not translate into more predictable ELP, better IOL centration, or improved visual outcomes in terms of final post-operative refraction and unaided visual acuity. In the hands of an experienced surgeon, the results are comparable.

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