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Neue Intraokularlinsendesigns f??r die Femtosekundenlaser-assistierte Kataraktoperation; New intraocular lens designs for femtosecond laser-assisted cataract operations;
摘要： The perfection and high reproducibility of capsulotomy in femtosecond laser-assisted cataract surgery (FLACS) lead to the possibility of new intraocular lens (IOL) designs for capsulotomy fixed implantation. Currently four different types of femtolenses for capsulotomy fixation are described in the literature or are commercially available. The first described was the lens in the bag or Tassignon IOL, which was developed for secondary cataract prevention, the second was the Masket IOL for reduction of negative dysphotopsia and third the 90F designed by Dick. All three types are or will be produced by Morcher. The fourth lens is the Femtis from Oculentis. All lenses are characterized by a high level of safety during implantation, The Tassignon lens leads to reduction of secondary cataract, especially in juvenile cataract because of the additional posterior capsulotomy. In studies the Masket IOL could show a decrease of negative dysphotopsia. In comparison to standard lenses, the 90F and Femtis in particular showed better results with respect to tilt, rotation and decentration. The new IOL designs for capsulotomy fixation show a safe implantation procedure and indications for a very stable position in the capsular sac. Further studies must be carried out to confirm the possible advantages in comparison to standard IOL with respect to postoperative results for refraction, tilt, rotation and decentration and possible induction of aberrations.
关键词： Femtolens,Femtosecond laser-assisted cataract surgery,Capsulotomy,Decentration,Tilt
更新于2025-09-23 15:21:01
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Zukunftsperspektiven des Femtosekundenlasers in der Vorderabschnittschirurgie; Future perspectives of the femtosecond laser in anterior segment surgery;
摘要： Around 12 years after its introduction laser cataract surgery (LCS) has enabled remarkable progress, such as extremely precise capsulotomy and lens fragmentation with reduced or no ultrasound energy at all (zero phako); however, another innovation push is necessary to bring this technology to its full potential. Among the many benefits that have not yet been fully explored are primary posterior laser capsulotomy (PPLC) and the use of the femtosecond laser in pediatric cataract patients. In the present collective of patients in whom a PPLC was carried out at the end of the operation, a clearly reduced prevalence of secondary cataract could be observed, whereas the short additional intervention was not associated with notable complications. The LCS in infants is best carried out as an off-label procedure, which has been rendered more precise by the Bochum formula. In the near future, postoperative laser fine tuning will enable the target refraction to be achieved in most patients. Laser-induced refractive index change (LIRIC) will enable very exact refraction alterations on an already implanted intraocular lens (IOL), on a contact lens and on a treatment native cornea. A new version of the Scheimpflug camera will be used just prior to surgery to analyze the morphology and kernel density of the lens opacity and to carry out a real-time grading of lens hardness. Based on this categorization, where the system classifies the results into five different density grades, the surgeon is automatically provided with an individualized fragmentation pattern defined preoperatively by the operator. A further innovation of the same system involves microcorneal incisions for fine tuning of residual refractive deficits.
关键词： Femtosecond laser-assisted cataract surgery,Bochum formula,Postoperative refractive enhancement/fine tuning,Primary posterior laser capsulotomy,Laser-induced refractive index change
更新于2025-09-23 15:19:57
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Comparison of optical quality and distinct macular thickness in femtosecond laser-assisted versus phacoemulsification cataract surgery
摘要： Background: Optical quality and macular thickness changing optical quality is rarely reported after femtosecond laser-assisted cataract surgery (FLACS). In current research, we evaluated optical quality recovery and distinct macular thickness changes after FLACS and phacoemulsification cataract surgery (PCS). Methods: A total of 100 cataract patients (100 eyes) were included (50 eyes for the FLACS group and 50 eyes for the PCS group). Modulation transfer function (MTF), point spread function (PSF) and dysfunctional lens index (DLI) were measured by a ray-tracing aberrometer (iTrace). Uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) were also assessed pre-operation,1 week and 1 month after surgery. The MTF values at spatial frequencies of 5, 10, 15, 20, 25 and 30 cycles/degree (c/d) were selected. We used optical coherence tomography (OCT) to assess the macular thickness of different regions pre-operatively and1month after the surgery. Results: In PCS group, we found the statistically significant differences between pre-operation and post-operation in DLI (p < 0.0001), PSF (strehl ratio, SR) (p = 0.027) and MTF (p = 0.028), but not intraocular pressure (IOP) (p = 0.857). The differences between pre-operation and post-operation for DLI (p = 0.031), SR (p = 0.01) and IOP (p = 0.03), but not MTF (p = 0.128) were also found in FLACS group. The differences were statistically significant when the spatial frequencies were at 5, 10 and 25 (p = 0.013, 0.031 and 0.048) between pre-operation and post-operation in PCS group but not FLACS group at 1 month. In PCS group, we found the differences between pre-operation and post-operation in nasal inter macular ring thickness (NIMRT) (p = 0.03), foveal volume (FV) (p = 0.034) and average retinal thickness (ART) (p = 0.025) but not FLACS group at 1 month. Conclusion: FLACS is safe that did not cause significant increase of macular thickness in current study. However, it also cannot produce better optical quality. In contrast, PCS can produce macular thickness changes, but better optical quality recovery. The slightly retinal change may not affect optical quality.
关键词： Macular thickness,Femtosecond laser-assisted cataract surgery (FLACS),Point spread function (PSF),Modulation transfer function (MTF),Phacoemulsification cataract surgery (PCS),Dysfunctional lens index (DLI),Optical quality
更新于2025-09-19 17:13:59
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Combined Femtosecond Laser-Assisted Cataract Surgery and 27-Gauge Transconjunctival Sutureless Vitrectomy
摘要： Purpose. To report the outcomes of combined surgery using femtosecond laser-assisted cataract surgery (FLACS) and sutureless 27-gauge pars plana vitrectomy with intravitreal tamponade. Methods. This retrospective clinical study involved 23 eyes of 23 patients on whom combined vitreoretinal surgery was performed. Patients were initially given the femtosecond laser treatment that was performed after selection of capsulotomy and lens fragmentation patterns. The capsulotomy diameter was chosen as 4.9 mm in all patients. After the femtosecond laser, the sutureless phacovitrectomy procedure was performed. At the end of surgery, perfluoropropane or sterile air tamponade was applied. Results. The mean age of patients was 66.43 ± 7.61 (range, 54–83) years. Fifteen patients were females (65.2%). The mean follow-up was 16.09 ± 4.71 (range, 9–25) months. The most common surgical indication was epiretinal membrane (65.3%). The mean preoperative best-corrected visual acuity (BCVA) was 0.71 ± 0.44 (range, 1.7–0.3) logMAR, and the mean postoperative BCVA at 6 months was 0.16 ± 0.14 (range, 0.4–0) logMAR (p < 0.001). The mean target sphere refractive error was ?0.24 ± 0.16 (range, ?0.50–0.11) D, and the mean postoperative spherical equivalent refractive error was ?0.14 ± 0.39 (range, ?1.00–0.50) D at 6 months (p = 0.196). All intraocular lenses (IOLs) remained well centered in the capsular bag during surgery and follow-up. There was no iris capture, posterior synechiae, capsular opacification, or pseudophakic cystoid macular edema. The only complication related to femtosecond laser was two cases of subconjunctival haemorrhage related with suction. Conclusions. FLACS is a safe and effective technique providing the advantage of repeatable, precise capsulorhexis shape and size to achieve a well-centered and stable IOL postoperatively. These advantages can certainly improve the results of vitrectomy, especially in gas-filled eyes. FLACS and 27-gauge sutureless combined surgery may be a future trend in appropriate cases.
关键词： phacovitrectomy,epiretinal membrane,intravitreal tamponade,femtosecond laser-assisted cataract surgery,27-gauge transconjunctival sutureless vitrectomy
更新于2025-09-19 17:13:59
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A prospective comparative study on endothelial cell loss and morphology after femtolaser-assisted cataract surgery and phacoemulsification
摘要： Purpose To compare changes in endothelial cell count and morphology at 6 months follow-up in eyes undergoing femtosecond laser-assisted cataract surgery (FLACS) and conventional phacoemulsi?cation. Design Prospective, comparative and open-label study. Methods All consenting patients between 50 and 75 years of age with uncomplicated cataract underwent either FLACS [Catalys Precision Laser System (OptiMedica Corp.; Abbott Medical Optics)] or conventional phacoemulsi?cation [Bausch ? Lomb Stellaris(cid:3) (Rochester, USA)] based on their preference and were followed up on day 15 and at 2 and 6 months postoperatively. The endothelial cell count (ECC), % of hexagonal cells and coef?cient of variation were noted at baseline and at each follow-up visit and compared between groups. Results A total of 187 eyes of 187 patients (n = 98 in phaco vs. n = 89 in FLACS) were enrolled. At 15 days follow-up, there was a signi?cant decline in the endothelial cell count in both groups (187 ± 156 in phaco vs. 193 ± 240 in FLACS, p < 0.001). In the ECC remained stable (8% decline in phaco vs. 7.7% decline in femto, p = 0.87) till last follow-up at 6 months. The %hexagonal cells also decreased signi?cantly at 15 days post-op (p < 0.001) but did not show any change in subsequent visits. The coef?cient of variation in ECC did not change signi?cantly throughout the study period. Eyes with higher endothelial cell count at baseline tended to lose more cells (b = 25.7 cells/mm3, 95% CI 16–35 cells, p = 0.01) irrespective of age and type of surgery. Conclusions Both procedures are equally safe with < 10% ECC loss at 6 months. Longer studies are required to determine in?uence of FLACS on ECC.
关键词： Hexagonal cells,Phacoemulsi?cation,Endothelial cell count (ECC),Femtosecond laser-assisted cataract surgery (FLACS)
更新于2025-09-19 17:13:59
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Comparison of the selected parameters of the anterior segment of the eye between femtosecond laser-assisted cataract surgery, microincision cataract surgery, and conventional phacoemulsification
摘要： The purpose of our study was to compare the selected parameters of the anterior segment of the eye in patients after femtosecond laser-assisted cataract surgery (FLACS) with the results of microincision cataract surgery (MICS) and conventional phacoemulsi?cation surgery (CPS). This single-center prospective randomized comparative observational study included 87 patients. Patients were randomly selected into group A (FLACS), group B (MICS) and group C (control group). All the surgeries were performed by the same experienced surgeon. Preoperative and postoperative parameters were evaluated: best-corrected visual acuity (BCVA), endothelial cell density (ECD), endothelial cell loss percentage (ECL%), central corneal thickness (CCT), central anterior and posterior corneal astigmatism induction, posterior corneal elevation map were measured. Intraoperative parameters: effective phacoemulsi?cation time (EPT), balanced salt solution use (BSS use), total surgical time and suction time were analyzed. Examination was performed preoperatively and on the ?rst, seventh day, one and six months postoperatively. The follow up period was 6 months. There was no statistically signi?cant difference in BCVA, central anterior and posterior astigmatism induction between studied groups. The ECL% was statistically signi?cant lower in the group A on the 7th day, 1 month and 6-months postoperatively (P < .05). The CCT was statistically signi?cant lower in the group A and in the group B than in the group C on the 7th postoperative day (P = .002). However, in the 6 months follow-up there was no statistically signi?cant difference in the CCT between studied groups (P = .133). We observed statistically signi?cant difference in change of the posterior corneal elevation map at the periphery assessed within the 90° to 120°meridian range between group A, group B and group C at every timepoint postoperatively (P < .05). The EPT and BSS use were statistically signi?cant lower whilst total surgery time was statistically signi?cant higher in the FLACS group (P < .05). To conclude in the 6 months follow-up there was statistically signi?cant difference found between eyes undergoing FLACS, MICS and CPS with respect to the posterior corneal elevation map assessed within the studied range, ECL%, EPT, BSS use and total surgery time. Postoperative BCVA, central anterior and posterior astigmatism induction, CCT were comparable between studied groups.
关键词： conventional phacoemulsi?cation surgery,femtosecond laser-assisted cataract surgery,clinical outcomes,manual phacoemulsi?cation,intraoperative parameters,microincision cataract surgery
更新于2025-09-12 10:27:22
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Intraocular Pressure Changes during Femtosecond Laser-Assisted Cataract Surgery: A Comparison between Two Different Patient Interfaces
摘要： Purpose. The aim of this retrospective cohort study was to evaluate intraocular pressure (IOP) changes during femtosecond laser-assisted cataract surgery (FLACS) using two di?erent patient interface systems. Methods. 116 eyes of 116 patients scheduled for cataract surgery were divided into 2 groups: group 1 (61 eyes) and group 2 (55 eyes) underwent FLACS using Catalys Laser with ?uid interface (liquid optics interface, LOI) and LenSx Laser with curved interface and soft contact lens (SoftFit), respectively. IOP was assessed using a portable rebound tonometer (Icare?) preoperatively, after docking, immediately after surgery, at one and seven days postoperatively. Results. In group 1, the mean IOP (±SD) was 14.1 ± 0.4 mmHg before surgery, 33.2 ± 1.1 mmHg after docking, and 21.4 ± 0.9 mmHg immediately after surgery. In group 2, the mean IOP was 13.8 ± 0.4 mmHg before surgery, 24.2 ± 1.4 mmHg after docking, and 20.2 ± 1.2 mmHg immediately after surgery. After the docking procedure, a statistically signi?cant increase in IOP from the baseline was found in both groups (p < 0.001). Moreover, no statistically signi?cant di?erence in IOP measured at 1 and 7 days postoperatively was observed compared with the preoperative values (p > 0.05) using both laser platforms. No intraoperative and postoperative complications were observed. Conclusions. FLACS suction phase resulted in a transient increase of IOP in both groups, especially with the LOI system, and it is probably related to the greater pressure of a suction ring and suction generated through the vacuum, independently from the e?ect of femtosecond laser itself.
关键词： femtosecond laser-assisted cataract surgery,LenSx Laser,intraocular pressure,Catalys Laser,patient interface systems
更新于2025-09-12 10:27:22
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Tomographic analysis of anterior and posterior surgically induced astigmatism after 2.2?mm temporal clear corneal incisions in femtosecond laser–assisted cataract surgery
摘要： To evaluate surgically induced astigmatism (SIA) of temporal clear corneal incisions (CCIs) on anterior and posterior corneal curvature after femtosecond laser–assisted cataract surgery (FLACS) using Scheimpflug tomographic measurements.
关键词： clear corneal incisions,Scheimpflug tomography,femtosecond laser–assisted cataract surgery,surgically induced astigmatism
更新于2025-09-12 10:27:22
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Comparison of Perioperative Parameters in Femtosecond Laser-assisted Cataract Surgery using Three Nuclear Fragmentation Patterns
摘要： Purpose: To compare the perioperative parameters of quadrant, sextant, and grid lens fragmentation patterns in femtosecond laser-assisted cataract surgery (FLACS). Design: Prospective randomized clinical trial. Methods: Setting: Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China. Patient or Study Population: A total of 894 eyes in 661 patients with cataracts were enrolled. Intervention or Observation Procedures: The nuclear density was graded according to the Emery-Little classification. Patients received lens fragmentation using a quadrant, sextant, or grid pattern after random allocation. Evaluations included intraoperative parameters, complications, and postoperative outcomes. Main Outcome Measure(s): Effective phacoemulsification time (EPT), intraoperative complications, visual acuity and intraocular pressure (IOP) at one day postoperatively, as well as endothelial cell density (ECD), endothelial cell loss (ECL) and central corneal thickness (CCT) at one week postoperatively. Results: In grade 1 nuclei, the mean EPT in the grid group was the shortest compared to those in the quadrant (P = 0.011) and sextant (P = 0.001) groups. In grade 2 nuclei, all three patterns showed no significant difference in the mean EPT (p > 0.05). In grade 3 nuclei, the sextant group revealed shorter mean EPT compared to the grid (P = 0.017) and quadrant (P > 0.05) groups. In grade 4 & 5 nuclei, the quadrant pattern had the shortest mean EPT among all three patterns (P < 0.05). The grid pattern is associated with higher IOP in hard nuclei (grade 4 & 5) than the other two patterns (P < 0.05). Conclusions: The grid and quadrant patterns allow for shorter EPT in soft (grade 1) and hard (grade 4 & 5) nuclei, respectively. All three patterns can be selected for treating grade 2 nuclei. The sextant pattern may be the best option when treating grade 3 nuclei. The grid pattern should be avoided in hard nuclei combined with glaucoma or glaucoma suspect.
关键词： nuclear fragmentation patterns,Femtosecond laser-assisted cataract surgery,Emery-Little classification,perioperative parameters,FLACS
更新于2025-09-12 10:27:22
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Femtosecond laser–assisted cataract surgery: A review
摘要： Purpose: Review scientific literature concerning femtosecond laser–assisted cataract surgery. Methods: Following databases were searched: CENTRAL (Cochrane Eyes and Vision Trials Register; Cochrane Library: Issue 2 of 12, June 2019), Ovid MEDLINE? without Revisions (1996 to June 2019), Ovid MEDLINE? (1946 to June 2019), Ovid MEDLINE? Daily Update June 2019, MEDLINE and MEDLINE Non-Indexed Items, Embase (1980–2019), Embase (1974 to June 2019), Ovid MEDLINE? and Epub Ahead of Print, in-Process & Other Non-Indexed Citations and Daily (1946 to June 2019), Web of Science (all years), the metaRegister of Controlled Trials (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrial.gov) and World Health Organization International Clinical Trials Registry Platform (www.who.int/ictrp/search/en). Search terms/keywords included ‘Femtosecond laser’ combined with ‘cataract’, ‘cataract surgery’. Results: Based on quality of their methodology and their originality, 121 articles were reviewed, including randomised controlled trials, cohort studies, case-controlled studies, case series, case reports and laboratory studies. Each step of the femtosecond laser–assisted cataract surgery procedure (corneal incisions, arcuate keratotomies, capsulotomy and lens fragmentation) has been discussed with relevance to published outcomes, as well as complication rates of femtosecond laser–assisted cataract surgery, and what we can learn from the larger studies/meta-analyses and the economics of femtosecond laser–assisted cataract surgery within different healthcare settings. Conclusion: Studies suggest that the current clinical outcomes of femtosecond laser–assisted cataract surgery are not different to conventional phacoemulsification surgery and it is not cost effective when compared with conventional phacoemulsification surgery. In its current technological form, it is a useful surgical tool in specific complex cataract scenarios, but its usage has not been shown to translate into better clinical outcomes.
关键词： Cataract,phacoemulsification,femtosecond laser–assisted cataract surgery
更新于2025-09-11 14:15:04