@article {Chee544, author = {Soon-Phaik Chee and Nicole Shu-Wen Chan and Younian Yang and Seng-Ei Ti}, title = {Femtosecond laser-assisted cataract surgery for the white cataract}, volume = {103}, number = {4}, pages = {544--550}, year = {2019}, doi = {10.1136/bjophthalmol-2018-312289}, publisher = {BMJ Publishing Group Ltd}, abstract = {Aim To report the capsulotomy and lens fragmentation outcomes of white cataracts managed with the femtosecond laser (FL).Methods Outcomes of a prospective, observational consecutive case series of white cataracts (June 2012{\textendash}November 2016) that underwent FL-assisted cataract surgery (FLACS) (Victus, Bausch+Lomb, Munich, Germany) at the Singapore National Eye Centre were audited. Data collected:~patient demographics, type of white cataract, levelness of docking, anterior capsule position following laser, completeness of capsulotomy and fragmentation, best-corrected visual acuity (BCVA) at 1 month, intraoperative complications. Outcome measures: capsulotomy integrity, fragmentation capability and BCVA at 1 month.Results 58 eyes of 54 patients underwent FLACS. White cataract types included dry white (24 eyes), intumescent (28 eyes) and Morgagnian (6 eyes). Docking was level in 22 eyes (38.6\%). Following FL, the anterior capsule level dropped in 20 eyes (34.5\%). Incomplete capsulotomies occurred in 10 eyes (17.2\%). Lens fragmentation attempted in 38 eyes was effective or partially effective in 31 eyes (81.6\%). No anterior or posterior capsule tears occurred. LogMAR BCVA at 1 month was 0.073 (SD 0.09). Risk factors for incomplete capsulotomy were Morgagnian cataract and lens thickness (multiple logistic regression, p\<0.01 and~p=0.03, respectively).Conclusion The main complication of FLACS in white cataracts was incomplete capsulotomy (17.2\%), significantly associated with Morgagnian cataracts and increased lens thickness. Lens fragmentation was effected in four-fifths of white cataracts but should be avoided in Morgagnian cataracts due to possible overlap of the lens fragmentation plan and the anterior capsule.}, issn = {0007-1161}, URL = {https://bjo.bmj.com/content/103/4/544}, eprint = {https://bjo.bmj.com/content/103/4/544.full.pdf}, journal = {British Journal of Ophthalmology} }