Nd:YAG Capsulotomy Rates: Femtosecond Laser–Assisted Cataract Surgery Versus Manual Phaco

Monday, April 20, 2015: 1:11 PM
Room 5A (San Diego Convention Center)
Valentina Vargas, MD
Dan B. Tran, MD
Lisa D. Garbutt, MD

To compare the Nd:YAG posterior capsulotomy rates after Cataract Surgery performed using a femtosecond laser (Lensx) vs Manual technique.

Retrospective chart analysis study of 1422 eyes that underwent cataract surgery between August 2011 and August 2013. The cases were divided into two groups depending on surgical technique FLACS (n=813) and Manual (n=609). The rate of Nd:YAG posterior capsulotomy was assessed for these two groups,  and then stratified by type of IOL implanted (accommodating, monofocal and multifocal).

The overall YAG rate was 10.4%; when stratified by surgical technique, FLACS rate was lower than Manual surgery (8.8% vs 12.6%). Accommodating IOLs had the highest Nd:YAG rates amongst all IOL groups, and there was no difference by technique (FLACS 20.1%, Manual 21.2%). Patients with multifocal IOLs operated with FLACS (6.2%) had significantly lower YAG rates than Manual (15.4%). Similar situation for Monofocal IOLs (7.4% vs 11.8%).

Femtosecond laser assisted cataract surgery creates a perfectly round, small, overlapping over the IOL edge, which enhances shrink-wrapping around the IOL, thus reducing the rate of PCO that requires Nd:YAG laser posterior capsulotomy in eyes implanted with IOLs with square edge (multifocal and monofocal IOLs).