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Purpose: To compare the techniques and refractive outcomes of H-FLACS with CCC, when using monofocal IOLs. To note, H-FLACS are fully mobile, handheld, suction-free and very significantly price efficient compared to traditional FLACS current generation.

Methods: A retrospective study of 9 patients operated for cataract with monofocal IOLs was conducted. H-FLACS was performed in one eye, and CCC was performed in the controlateral eye by the same surgeon – with no systematization of the technique used for the first eye. H-FLACS procedures were used to perform a 5-mm anterior capsulotomy in the induction room. Safety, 4-days and/or 30-days postoperative visual evaluation were analyzed.

Results: No adverse events were reported in any of the groups. Data at 4-days and 30-days post-operation was available for 7 and 5 patients respectively. At 4 days post-operation in the H-FLACS group, 85.7% (n=6) and 100% (n=7) of eyes had spherical equivalent refraction (SER) of ±0.50 D and ±1.00 D respectively. In the CCC group, there were 100% (n=7) of eyes with SER of ±0.50 D. In both groups at day 30, 80% (n=4) and 100% (n=5) of eyes had SER of ±0.50 D and ±1.00 D respectively.

Conclusions: As expected for monofocal IOLs, no statistical differences in visual outcomes were observed between both groups. H-FLACS demonstrate the same level of safety, reproducibility and standardization as FLACS, while being easier to use, much more integrated into surgical workflows, and much less expensive (3 to 4 times less expensive). Given these results obtained with monofocal implants, we expect refractive outcomes with H-FLACS to be similar to those with FLACS when using premium implants.