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Femtosecond laser energy tuning during cataract surgery and the development of a relevant nomogram

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Session Details

Session Title: Femtocataract I

Session Date/Time: Sunday 14/09/2014 | 08:00-10:00

Paper Time: 08:36

Venue: Boulevard A

First Author: : R.Bellucci ITALY

Co Author(s): :    S. Morselli   M. Cargnoni           

Abstract Details


Femtosecond laser action is affected by tissue hardness and transparency, while phacoemulsification is only affected by hardness. Since laser energy cannot be adjusted during the procedure, we need some indication to pre-adjust the energy required for lens fragmentation.


CEMS medical centre, Verona, Italy


A number of 50 eyes undergoing femtolaser cataract surgery with the Victus femtosecond laser were classified according to the LOCS III cataract classification system. The two scores of nucleus colour/opacity and of cortical opacity were added to obtain a single score ranging from 2 (minimum) to 11( maximum). The laser energy was regulated according to the LOCS III score, from 7.2 μJ to 8.1 μJ per pulse. Pulse spacing was not varied. At surgery, the fragmentation obtained was evaluated from 1 (poor) to 4 (optimal). Phacoemulsification times were also recorded.


All the lenses were nicely fragmented by the femtosecond laser. Fragmentation was judged poor in 2 eyes with soft cataracts, and in 3 eyes with very dense and opaque nuclei. Phacoemulsification times were higher in these 3 eyes. As compared with the use of fixed energy level, the adopted nomogram produced large saving of energy without affecting laser efficacy.


The adopted nomogram is very simple, yet produced interesting results. It needs refinement by including pulse spacing for very soft lenses, and higher energy for very dense and opaque cataracts.

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

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