Chee SP, et al. - In this randomized controlled trial, researchers compared the benefit of femtosecond laser-assisted cataract surgery (FLACS) vs phacoemulsification (PE) and two fragmentation patterns in managing dense cataracts. Patients with nuclear opacity grade > 5 (LOCS III) were selected at the Singapore National Eye Centre. Patients unfit for FLACS, corneal endothelial cell count (ECC) < 1500 cells/mm ² or cataracts with additional complexities were exempted from the study. Eyes have been randomized to PE, 600μm grid (FLACSg) or 16 segment fragmentation (FLACS16) at 2:1:1 ratio. Ninety-three patients were randomized into 48 PE, 22 FLACSg and 23 FLACS16. Findings suggested that the mean ECC loss during phacoemulsification in dense cataracts was significantly reduced by FLACSg but not FLACS16.