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Zero phaco femto laser-assisted cataract surgery (FLACS)

Poster Details

First Author: S.Chaudhary INDIA

Co Author(s):                        

Abstract Details


FLACS is an established technique to reduce the phaco energy utilization to nearly 50%. However, with the grid pattern of nucleotomy in a cataract of up to grade 3, it is possible to do a zero phaco surgery. This means that the nucleus can now be removed with just Irrigation and Aspiration. This is a great advancement for FLACS as this would result in greater safety to the endothelium and clearer cornea's on first post-op day.


Eye7 Hospitals, New Delhi, India


The grid pattern nucleotomy of the LenSx system is used to divide the nucleus into multiple small fragments. The laser cuts the nucleus into longitudinal spindles which are sliced in two horizontal planes to create multiple small pieces.With a 20g mini-flared Kelmen phaco tip with sleeve, inserted through a 2.2 mm incision,with a vaccuum of 550 mm hg., and a flow rate of 40 cc/min, it is possible to aspirate out the nuclear pieces and the epinucleus in the Irrigation-Aspiration mode of the Phaco machine.


Aspirating Femto laser chopped nuclear pieces in grade I cataract is simple, in grade II a shade difficult, and in grade III a challenge. The surgeon was not successful in aspirating a grade IV chopped nucleus by this technique


Reducing the phaco power requirement for nucleus removal is the most endothelial friendly surgical technique. Bringing the phaco power to zero with the help of FLACS is a giant step in this direction. This results in decreased loss of endothelial cells and better corneal clarity on first post-op day.

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