Femtosecond Laser-Assisted Cataract Surgery (FLACS): Is There Any Adjustment Needed for IOL Calculations?

Modern cataract surgery has progressed from basic displacement of an opacified lens, initially by couching, first reported by Sushruta in 600 bce (before the common era), followed 2200 years later by the dramatic improvement to extracapsular cataract surgery by Jacques Daviel in 1747, to which Sir Nicholas Harold Lloyd Ridley contributed monumentally 200 years later with intraocular lenses in 1949, completing the groundwork to set the stage for modern enhancements. Charles David Kelman introduced phacoemulsification in 1967, which led to smaller incisions and foldable intraocular lens (IOL). Cataract surgery is now progressing, in the 2000s, to include astigmatic and presbyopia correcting IOLs, laser-based corneal refractive correction techniques, and now femtosecond laser-assisted cataract surgery (FLACS). Cataract surgery has become a highly refined, individualized refractive procedure aimed at optimizing postoperative visual outcomes for every eye. This evolution has also depended upon the development of increasingly sophisticated IOL power calculation formulas and progressively accurate preoperative measurement techniques. As always happens with progress, patient expectations jump ahead of realistic expectations and now extend to spectacle independence and excellent visual quality, irrespective of the starting point, often exceeding anything the patients have ever experienced before in their lives [1].