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Comparison of effective lens position and refractive outcome in monofocal and multifocal IOLs: femtosecond laser vs manual capsulotomy

Session Details

Session Title: Cataract I

Session Date/Time: Friday 03/02/2012 | 10:30-12:30

Paper Time: 11:17

Venue: Hall 1

First Author: : Z.Nagy HUNGARY

Co Author(s): :    R. Cionni, M.D.   K. Solomon, M.D.           

Abstract Details


IOL formulas assume that the IOL will sit at the equatorial plane of the capsule without consideration for variability in capsulorhexis shape or size. In this study, we compare the variability and predictability in ELPo and refractive outcome based on capsulotomy created by a femtosecond laser with those using manual continual curvilinear capsulorhexis.


Multi-Center Study at Private Ophthalmology Practices and University Setting


100 eyes eligible for cataract surgery had either a refractive capsulotomy performed using the LenSx femtosecond laser (Alcon LenSx, Inc.) in one group (n=50) and a capsulorhexis of the same size (5.0 mm) was attempted manually in the other group (n=50). After lens removal, 25 eyes within each group were implanted with a monofocal lens (Alcon SN60WF); the remaining 25 eyes within each group were implanted with a multi-focal lens (Alcon ReStor SN6AD1). Accuracy and predictability to target refraction, as well as standard visual outcomes were compared between the two groups at 1 month post-op. RESULTS Improvement in precision of IOL position as shown by reduced variability of ELP in the laser group was observed at one month for both IOL types. There was also an improvement in accuracy to target refraction between the two groups, with 43% more monofocal eyes within 0.25D of target refraction in the laser group compared to the manual group, and 30% more multifocal eyes compared to manual eyes. Standard 1-month visual outcomes were also superior in the laser group for both IOL types (73% 20/20 or better in laser group vs 46% in manual group).


A main source of post-operative refractive unpredictability is the final position of the IOL optic. The use of a femtosecond laser to create precisely sized, shaped and centered capsulotomies resulted in better predictability in IOL power calculation and improved refractive outcome predictability in both monofocal and multifocal IOLs.

Financial Disclosure:

... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, ... research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented