J Korean Ophthalmol Soc > Volume 58(5); 2017 > Article
Journal of the Korean Ophthalmological Society 2017;58(5):539-545.
DOI: https://doi.org/10.3341/jkos.2017.58.5.539    Published online May 15, 2017.
Possible Risk Factors Affecting Successful Femtosecond Laser-assisted Cataract Surgery.
Heon Yang, Sang Youp Han, Kyung Heon Lee
Sungmo Eye Hospital, Busan, Korea. medicalhan@daum.net
성공적인 펨토초레이저 백내장수술을 위한 수술 중 합병증 위험인자 분석
양 헌⋅한상엽⋅이경헌
Correspondence:  Sang Youp Han,
Email: medicalhan@daum.net
Received: 12 January 2017   • Revised: 29 March 2017   • Accepted: 25 April 2017
To determine the risk factors of intraoperative complications in femtosecond laser-assisted cataract surgery. METHODS: This study included 598 eyes of 337 patients who underwent femtosecond laser-assisted cataract surgery (FLACS) between July, 2012 and January, 2017. All eyes had corneal incisions, anterior capsulotomy, nuclear fragmentation, and limbal relaxing incisions (if required). Intraoperative complications were analyzed by watching videos, and the related factors of each complication were retrospectively reviewed alongside the medical records. RESULTS: The mean age of the patients was 62.1 ± 11.9 years. Among the study group, 18 eyes required manual creation of corneal incisions; because the corneal incisions could not be made due to corneal central opacity, corneal peripheral degeneration, ptreygium, conjunctival chalasis, or idiopathic. The anterior capsulotomy was incomplete in 43 cases and manual capsulorrhexis was required for completion. These cases were associated with various conditions, including hypermature cataract, anterior polar or subcapsular cataract, corneal central opacity, pupillary abnormality, lens subluxation, poor pupil dilation, and idiopathic. Overall, 22 eyes had difficulties with nuclear fragmentation, with either mature cataract, lens subluxation, corneal central opacity, anterior polar or subcapsular cataract, or pupillary abnormality. Using the Laser SoftFit™ patient interface decreased the incidences of incomplete corneal incision (from 3.56% to 2.24%, p = 0.367), anterior capsulotomy (from 9.31% to 4.03%, p < 0.05), and nuclear fragmentation (from 5.20% to 1.34%, p < 0.05). The incidences of complications in the experienced group was statistically lower compared with the novice group (p < 0.05 for all comparisons). CONCLUSIONS: The femtosecond laser platform was effective and safe for cataract surgery. However, in the presence of related factors, use of this platform might need to be re-assessed and should be considered for intraoperative complications. Additionally, with the Laser SoftFit™ patient interface and improved surgeon experience, better intraoperative results can be expected for FLACS surgery.
Key Words: Anterior capsulotomy;Corneal incision;Femtosecond cataract surgery;Nuclear fragmentation;Related factors

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