Abstract：Objective To summarize instrument parameter settings of femtosecond laser-assisted phacoemulsification surgery, to analyse intraoperative and postoperative problems and the solutions. Methods As a prospective case series study. 67 eyes undergoing femtosecond laser-assisted phacoemulsification with the LenSx femtosecond laser treatment equipment (Alcon Inc.) between March and December 2014 in this hospital were included in the study. Patients aged 42-72 years. Nuclear hardness Ⅱ-Ⅳ grades (according to Emery nuclear hardness grade standards). Parameter settings: anterior capsulotomy diameter of 4.9 mm, chopping nucleus diameter of 5.1 mm, the central ring chopping nucleus diameter of 2.7 mm, primary incision 2.2 mm wide and 1.4 mm long, auxiliary incision 1.0 mm wide and its cutting angle 30 degrees. Results Of all 67 cases observed, no cases developed suction break. Corneal incision: primary incision and auxiliary incision completely cut in 49 cases (73.13%), manual assist ance of making primary incision in 11 cases (16.42%), manual assist ance of making auxiliary incision in 9 cases (13.43%). Anterior capsulotomy: 65 cases (97.01%) had a centered capsulotomy. The resected capsular disc in the 43 cases (64.18%) was completely free-floating, an anterior capsule tear occurred in 3 cases (4.48%). Chopping nucleus: only 4 white cataract cases (5.97%) had not completly chopping nucleus, other patients all had a satisfactoried chopping nucleus. No cases of capsular blockage syndrome (CBS) or posterior capsule rupture (PCR) and nucleus falling occurred. 21 cases (31.34%) developed significantly conjunctival hemorrhage. All of the patients after laser treatment had different degrees of miosis. Among them, 8 eyes’ pupil diameter (11.94%) was less than the anterior capsulotomy diameter. All patients successfully completed phacoemulsification surgery and intraocular lens implantation. Conclusions Femtosecond laser-assisted phacoemulsification surgery accurately determines capsulotomy size, shape and position, determines the intraocular lens centraction and stability, reduces the ultrasound energy, and also can improve the precision and quality of cataract surgery. The effect of anterior capsulotomy and chopping nucleus is satisfactory, but the accuracy of the position and depth of main, auxiliary incision is yet to be further exploration.
Johansson B, Lundstrom M, Montan P, et al. Capsule complication during cataract surgery: Long-term outcomes: Swedish capsule rupture study group report 3[J]. J Cataract Refract Surg, 2009, 35(10): 1694-1698.
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2015, Vol. 26 
