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    Femtosecond laser use shows very low rate of capsule tears

    Improved technology and surgeon experience now results in a perfectly circular, evenly sized and intact capsulotomy in nearly 100% of cases

    As early as 2009, people were beginning to realize the demand for perfect outcomes after cataract surgery was growing concomitantly with the popularity of premium IOLs, and that femtosecond laser technology may be a novel means to create circular capsulorhexis with even greater precision than manual techniques.

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    By 2014, the literature was starting to show the femtosecond laser can create more stable refractive results, with more precision and better capsulotomy sizing than manual procedures. Two clinical issues observed early during the learning curve were capsular block syndrome and anterior capsule tears. A large, long-term study presented during the 2016 meeting of the American Society of Cataract and Refractive Surgery has found no further case of capsular block and a very low rate of anterior capsule tears, indicating that the significant advances in laser technology, patient interfaces and surgical technique have now resolved these issues.

    Tim Roberts, MBBS, MMed, FRANZCO, FRACS, GAICD, medical director of the Vision Eye Institute and with the Save Sight Institute, University of Sydney (Australia) and colleagues prospectively evaluated all eyes undergoing femtosecond laser cataract surgery (FLACS) with the LenSx FS laser (Alcon Laboratories) between April 2012 and September 2015 at the Vision Eye Institute. (In Australia, patients pay out-of-pocket for the procedure, ranging from $600 to $950; Dr. Roberts’ conversion rates hover around 95%, as his group is known as a specialist laser cataract surgery practice and has a high level of referrals as a result.)

    Large cohort study

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