Deviation between programmed and actual capsulotomy diameter in femtosecond laser-assisted cataract surgery: a clinical study of influencing factors and predictive modeling.

BACKGROUND

Differences between actual and programmed capsulotomy diameter were found in femtosecond laser-assisted cataract surgery (FLACS). This study aimed to evaluate the deviation between the programmed (PDC) and actual (ADC) diameters of the capsulotomy in FLACS, identify the influencing factors, and establish a predictive model to improve the accuracy of capsulotomy size.

METHODS

This retrospective study included 47 eyes from 47 adult patients who underwent FLACS. The ADC was measured using Image Pro Plus version 6.0 based on intraoperative video images, and the diameter deviation of the capsulotomy (DDC) was calculated by subtracting the PDC from the ADC. Correlation analysis was used to assess the relationships of demographics and ocular biometrics with ADC and DDC. Multiple linear regression was conducted to develop a model for predicting ADC.

RESULTS

The mean ADC (5.99 ± 0.34 mm) was significantly greater than the PDC (5.67 ± 0.15 mm, P < 0.001) in the overall cohort. The average DDC was 0.33 ± 0.31 mm, with 63.8% of eyes exhibiting a DDC greater than 0.20 mm. Correlation analysis showed that age was significantly negatively correlated with both ADC and DDC, and this correlation remained significant after adjusting for other ocular biometrics. Stepwise multiple linear regression identified age and PDC as independent predictors for ADC, yielding the following formula: ADC = 2.531 - 0.011·Age + 0.741·PDC (F = 14.265, P < 0.001; adjusted R2 = 0.366, Durbin-Watson statistic = 2.294).

CONCLUSION

Age was identified as the most significant factor influencing DDC. The proposed regression model for ADC may aid surgeons in preoperative planning for a more accurate and individualized capsulotomy diameter.