Parameters influencing the effectiveness of femtosecond laser-assisted capsulotomy in white cataract surgery

Purpose: To explore the parameters that may influence the effectiveness of femtosecond laser- assisted capsulotomy in white cataract surgery and its cutoff points. Design: A retrospective case series. Methods: This retrospective case series study enrolled patients with white cataract who had undergone surgery at Changsha Aier Eye Hospital from July 2018 to January 2020. All patients underwent femtosecond laser-assisted capsulotomy using a contact femtosecond laser device (LenSx, Alcon Laboratories, USA). The sex, age, corrected distance visual acuity (CDVA), intraocular pressure (IOP), axial length (AL), lens thickness (LT), anterior chamber depth (ACD) and mean keratometry (Km) were recorded. All eyes were divided into successful capsulotomy group and unsuccessful capsulotomy group according to the capsulotomy integrity. Both groups were compared and two-sample t-test was used in order to find the optimal cutoff points of the parameters. Results: 60 eyes of 59 patients were included in the study. A successful capsulotomy was achieved in 36 eyes (60 %), while unsuccessful capsulotomy occurred in 24 eyes (40 %). Although no significant differences were observed in sex (P P = 0.704), AL (P P = 0.598) and Km (P P = 0.873) between both groups, LT (P P < 0.01), ACD (P P = 0.014) and age (P P < 0.01) were significantly different; a LT of 5.21 mm was found to be the optimal cutoff point. Conclusions: Femtosecond laser-assisted capsulotomy in white cataract is safe and effective. LT, ACD and age may influence the effectiveness of femtosecond laser-assisted capsulotomy in patients with white cataracts. LT is the main associated parameter and 5.21 mm is the optimal cutoff point for LT.