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Femtosecond laser-assisted cataract surgery (FLACS) combined with arcuate incisions (AI) for astigmatism correction using the LENSAR™ laser system

Poster Details

First Author: D.Holland GERMANY

Co Author(s):    J. Foerster   N. Grada   T. Herbst              

Abstract Details


Cataract surgeons across the world are increasingly adopting femtosecond laser technology, particularly due to its potential to improve the predictability, safety and efficacy of the cataract surgery. The LENSAR femtosecond Laser System™ integrates automated biometry, advanced ocular imaging and measurement technologies, 3D-CSI™ (Confocal Structured Illumination) with an advanced ultra-short pulse laser, thereby enabling the system to perform capsulorhexis, lens fragmentation, clear corneal incisions for cataract surgery and arcuate incisions (AI). The present study aims to evaluate the outcomes of the femtosecond laser assisted combined cataract surgery and AI for the treatment of cataract with pre-existing astigmatism using LENSAR Femtosecond Laser.


Augenklinik Bellevue, Kiel, Germany. An ethic committee approval is present.


The study included 30 eyes 20 patients with cataract and preexisting corneal astigmatism that underwent femtosecond laser assisted cataract surgery (FLACS) combined with arcuate incisions (AI) for astigmatism correction. (Mean age 68 years (±9 years)). Surgeries were performed by a single surgeon. Femtosecond laser assisted capsulotomy, lens fragmentation, clear corneal cataract incisions (2.4 mm) and AI were performed using the LENSAR femtosecond Laser System™. Phacoemulsification was performed using phaco system by Oertli, Switzerland. Pre- and postoperative corneal astigmatism was measured by Zeiss IOL Master, Keraton scout and Schwind Sirius camera. All patients were followed up for up to 6 months.


No laser associated intraoperative complication was observed in any of the 30 eyes. There was no instance of perforation of the cornea due to the AI in any case. Suction time for diagnostic imaging, capsulorhexis, nucleus fragmentation and AI was around 3 minutes. The amount of corneal astigmatism was significantly reduced in all the patients (Findings were same when measurements were performed with different devices). On average, the corneal astigmatism reduced by around 60% (Mean corneal astigmatism changed from 2.1 D pre-operatively to 1.0 D post-operatively). No over correction occurred. Mean UDVA was 0,8 and mean CDVA was 1,0 post-operatively.


The results of the study demonstrate the safety and efficacy of the combined cataract and AI procedure using the LENSAR platform. Nomogram improvements are needed to allow further reduction of astigmatism. The possibility of treating the corneal astigmatism as well as cataract in the same operation in a standardized way is another advantage of FLACS compared to the conventional phacoemulsification technique.

Financial Disclosure:

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

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