gms | German Medical Science

27th International Congress of German Ophthalmic Surgeons

15. to 17.05.2014, Nürnberg

Safety prosecution: Laser refractive lens surgery is not safer

Meeting Abstract

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  • Ekkehard Fabian - Augencentrum Rosenheim, Ambulante Operationen, Tagesklinik, Rosenheim

27. Internationaler Kongress der Deutschen Ophthalmochirurgen. Nürnberg, 15.-17.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocH 6c.27

doi: 10.3205/14doc025, urn:nbn:de:0183-14doc0252

Published: May 5, 2014

© 2014 Fabian.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Cataract surgery today is one of the most safest surgery procedure in medicine. If a new technology will rise savety it has to proof that. Main Items of FLACS and premium IOL implantation that are in focus in respect of precision and savety are:

Incisions: There had been advices that incisions too corneal can facilitate a leakage and thus could enhence cases of endophthalmitis.

Problem: Incisions with the femtocataract laser systems are all clear corneal.

Limbal Relaxing Incisions (LRI): Recurrance of astigmatisme after 1–2 years is a common phenomen.

Problem: The more precise incisions with the laser did jet not proove results with longer stability.

Capsulotomy: problems with laser created capsulotomies as tags and bridges are still an issue, clinical outcomes with better results are not convincing.

Problem: it is jet not prooven, if capsulotomies with better precision contribute to more savety and better refractive outcomes.

Corneal Endothelium: reduction of U/S engery has jet not proven better outcomes in refractive cataract cases.

Problem: publicated results are to be questioned in respect to anterior chamber depth, pachymetrie and cell counting procedures.

Lens Fragmentation: those eyes most recommended for FLACS, refracitve lens surgery with implantation of premium IOL´s do not need pretreatmend of lens fragmentation.

Problem: no prooven saftey aspects.

Overall aspects: There is still a lack of the so called “wow effect” that makes it a “MUST” in contrast to the standard of care in cataract surgery: the U/S-phacoemulsification. The relationship of safety aspects and oeconomical burdens are jet not in balance.