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5 years of FS-assisted cataract surgery

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Session Details

Session Title: Presented Poster Session: FLACS & Others

Venue: Poster Village: Pod 1

First Author: : P.Hoffmann GERMANY

Co Author(s): :                  

Abstract Details


A lot of data on fs-laser assisted cataract surgery (FLACS) emerged during the last years. Most of it is focussed on process quality, complications and innovative applications. We wanted to know if there is proof of comprehensible improvement for the patient (result quality).


Augen- & Laserklinik Castrop-Rauxel


From July 2012 until March 2017, 1494 FLACS procedures were performed by two experienced surgeons using the Victus fs-Laser platform. A 5.0 to 5.2 mm capsulotomy was centred on the presumed crystalline lens apex. Nucleus cuts were either a radial pattern or “french fries” style fragmentation. Incision width was 2.2 mm. As a measure of result quality, visual acuity, corneal swelling, endothelial loss, axial IOL position, wavefront aberrations and refractive prediction error were examined. 140 eyes operated manually acted as a control group. In a smaller subgroups (n = 30) IOL decentration and tilt was measured with Schaeffel’s purkinjemeter.


Slight improvements could be observed regarding corneal swelling and ECC loss. We found no significant or relevant differences between segmentation and “french fries” fragmentation for swelling or ECC loss. Refractive prediction error was not different at 1 month, but at 6 months the FLACS eyes had a smaller standard deviation 0.34 vs 0.43 D. The predictability of axial IOL position was slightly better in the Femto group. Higher order aberrations were slightly lower in the FLACS group, especially coma. Anterior capsular rupture rate was 0.8% (slightly higher than phaco), posterior capsular rupture rate was 0.2% (same as phaco).


FLACS is an innovative surgical procedure coming at a very high expense. For the patient, it is important to know if any improvement in result quality over conventional phacoemulsification can be gained. This gain could be due to better positioning of the IOL and more gentle removal of the nucleus. We could observe slightly less endothelial trauma with FLACS and better lateral as well as better axial IOL positioning (refractive predictability) ≥ 6 months after surgery. FLACS is a slight but comprehensible improvement on already very good quality manual phacoemulsification.

Financial Disclosure:


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