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Inter-eye comparison of FLACS capsulotomy and manual capsulorhexis edge strength

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Session Details

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

Session Date/Time: Monday 09/10/2017 | 08:30-10:30

Paper Time: 10:02

Venue: Room 4.4

First Author: : A.Siu AUSTRALIA

Co Author(s): :    U. Pattamatta   M. Butlin   K. Meades   C. Bala   T. Chan        

Abstract Details


To prospectively compare the breaking force needed to tear the explanted capsule following FLACS surgery in the worse eye and manual cataract surgery in the contralateral eye.


Private Ophthalmic Clinic


This was a Prospective non-randomised paired eye study. Patients prospectively underwent FLACS surgery with LenSx laser (Alcon) in the worse eye and manual cataract surgery in the better eye. The explanted capsule was stretched mechanically and the breaking force and strain were compared. Eyes where there was a large difference between laser and manual surgery were further examined with scanning electron microscopy to determine if morphological imperfections underpinned the weakness.


Paired samples of 78 eyes from 39 patients were tested. The mean breaking force for the manual capsulotomies (2.3g ± 2.0g; mean ± std) was not significantly different from Lensx capsulotomy (2.0g ± 2.2g; mean ± std; paired student’s t-test; p=0.52). The breaking strain for the manual samples (33.8% ± 18.3%; mean ± std) and for the LenSx samples (34.6% ± 18.6%; mean ± std) were also not significantly different (paired student’s t-test; p=0.81). Five patient’s FLACS capsule need considerably less force to break than their manual capsulotomies.The SEM images of these samples did not show any specific laser imperfections.


The femtosecond laser capsulotomies created by the LenSx laser platform are as strong as manual capsulotomies in paired living human subjects.

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