Scott WJ, et al. - This investigation examines the frequency of anterior capsule tears and capsule edge irregularities in femtosecond laser anterior capsulotomy, including the effect of optimized vertical spacing settings. By using manufacturer default settings with a vertical spacing of 10, 15, and 20 µm, 3834 cases were analyzed and grouped according to the femtosecond laser capsulotomy. Intraoperatively, capsulotomy edge irregularities and anterior capsule tears were recorded. For the 10, 15, and 20 µm groups the anterior capsule tear rates were 0.79%, 0.35%, and 0.09%, respectively. Capsule edge irregularity rates for the 10, 15, and 20 µm groups were 6.25%, 1.13%, and 1.15%, respectively. It was observed that with femtosecond laser cataract surgery, anterior capsule tear rates are low. Further reduction in the rate can be achieved by optimizing the setting along with an increase in the vertical setting.