The LenSx Laser System is indicated for use: - In the creation of corneal cuts/incisions, anterior capsulotomy and laser phacofragmentation during cataract surgery. Each of these procedures may be performed either individually or consecutively during the same surgery. - In the creation of a lamellar cut/resection for lamellar keratoplasty, and in the creation of a penetrating cut/incision for penetrating keratoplasty - In the creation of a corneal flap in patients undergoing LASIK surgery or other treatment requiring initial lamellar resection of the cornea
Device Story
LenSx Laser System uses focused femtosecond laser pulses for photodisruption of ocular tissue; creates incisions/separates tissue in lens capsule, crystalline lens, and cornea. System directs laser beam via computer-controlled scanning system in 3D patterns; pulses delivered through sterile, disposable applanating lens and suction ring assembly. Operated by clinicians in surgical settings. Modifications include increased laser repetition rates (up to 150 kHz for flaps, 50 kHz for other procedures) and software updates for flap patterns. Output allows precise corneal/lens incisions; facilitates cataract surgery, keratoplasty, and LASIK flap creation. Benefits include improved surgical precision and reproducibility compared to manual techniques.
Clinical Evidence
Bench testing only. Evaluated accuracy and reproducibility of depths, geometry, and energy stability of treatment patterns compared to predicate device criteria. Evaluated accuracy, reproducibility, and surface quality of lamellar resections.
Technological Characteristics
Femtosecond laser system; photodisruption principle. Max average power 1 Watt. Repetition rates: 150 kHz (flaps), 50 kHz (cataract/keratoplasty). Sterile disposable patient interface (applanating lens/suction ring). Software-controlled 3D scanning system. Connectivity: GUI-based control.
Indications for Use
Indicated for patients undergoing cataract surgery, lamellar or penetrating keratoplasty, or LASIK surgery/treatments requiring initial lamellar resection of the cornea.
Regulatory Classification
Identification
A phacofragmentation system is an AC-powered device with a fragmenting needle intended for use in cataract surgery to disrupt a cataract with ultrasound and extract the cataract.
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K120732
SEP 6 2012
## 510(K) SUMMARY
This 510(k) summary of safety and effectiveness information is being submitted in accordance with the requirements of 21 CFR 807.92(a).
# SUBMITTER'S NAME, ADDRESS, TELEPHONE NUMBER, CONTACT PERSON, AND DATE SUMMARY PREPARED
| a. | Applicant: Alcon LenSx, Inc.<br>33 Journey<br>Aliso Viejo, CA 92656<br>Tel: (949) 360-6010<br>Fax: (949) 360-6028 |
|----|-------------------------------------------------------------------------------------------------------------------|
| b. | Contact Person: Judy Gordon, D.V.M. |
Judy Gordon. D.V.M. ClinReg Consulting Services, Inc. 733 Bolsana Drive Laguna Beach, CA 92651 judy@clinregconsulting.com Tel: (949) 715-0609 Fax: (949) 715-0610
Date:
c.
b.
d.
August 8, 2012
### NAME OF DEVICE, INCLUDING TRADE NAME AND CLASSIFICATION NAME
- LenSx Laser System Trade/Proprietary Name: a.
- Common/Usual Name: · LenSx Laser System
- Laser Instrument, Surgical, Powered Classification Name: c.
- 21 CFR 886.4390; OOE, HQC, HNO Classification Code(s):
#### PREDICATE DEVICES
| 510(k) # | TRADE NAME | MANUFACTURER |
|----------|----------------------------------|-----------------------------------------------------|
| K101626 | LenSx Laser System | LenSx Lasers, Inc.<br>(now Alcon LenSx, Inc.) |
| K993153 | IntraLase Laser | IntraLase Corp.<br>(now Abbot Medical Optics, Inc.) |
| K041893 | | |
| K060372 | | |
| K073404 | | |
| K101006 | WaveLight FS 200<br>Laser System | Alcon Research, Ltd. |
| K033354 | Femtec Laser Microkeratome | 20/10 Perfect Vision<br>Optische Gerate GmbH |
| K100253 | Visumax Laser Keratome | Carl Zeiss Meditec |
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#### DEVICE DESCRIPTION
The LenSx Laser System uses focused femtosecond laser pulses to create incisions and separates tissue in the lens capsule, crystalline lens, and the cornea. Individual photodisruption locations are controlled by repeatedly repositioning the laser focus. The light pulse is focused into a sufficiently small spot in order to achieve photodisruption of the tissue inside the focus. A tiny volume of tissue, a few microns in diameter, is thereby photodisrupted at the laser focus. The surgical effect is produced by scanning thousands of individual pulses per second to produce a continuous incisions or tissue separation.
The location of the tissue photodisruption is controlled by moving the focus of the laser beam to the desired surgical target location. A computer-controlled scanning system directs the laser beam throughout a three-dimensional pattern to produce an incision. The laser pulses are delivered through a sterile, disposable applanating lens and suction ring assembly that contacts the cornea and fixes the eye with respect to the delivery system.
The LenSx Laser System proposed in this 510(k) premarket notification is a modification of the previously cleared LenSx Laser System, manufactured by Alcon LenSx, Inc. (K101626). It is essentially the same laser system with the addition of a new indication for use, namely the creation of a corneal flap in patients undergoing LASIK surgery or other treatments requiring initial lamellar resection of the cornea. This same indication has been cleared for use with multiple predicate femtosecond laser devices since 1999, including the IntraLase Laser (K993153, K041893, K060372, and K073404), the WaveLight FS 200 Laser System (K101006), the Femtec Laser Microkeratome (K033354), and the Zeiss Visumax Laser . Keratome (K100253). Femtosecond lasers now perform the majority of LASIK flaps in the United States and virtually all those performed by the US Armed Forces, with numerous articles documenting their use and advantages. 67,8
## STATEMENT OF INTENDED USE
The LenSx Laser System is indicated for use:
- · In the creation of corneal cuts/incisions, anterior capsulotomy and laser phacofragmentation during cataract surgery. Each of these procedures may be performed either individually or consecutively during the same surgery.
- · In the creation of a lamellar cut/resection for lamellar keratoplasty, and in the creation of a penetrating cut/incision for penetrating keratoplasty
- · In the creation of a corneal flap in patients undergoing LASIK surgery or other treatment requiring initial lamellar resection of the cornea
<sup>6</sup> Panday VA. Reilly CD. Refractive surgery in the United States Air Force. Current Opinion in Ophthalmology 2009, 20:242-246.
<sup>7</sup> Kim P, Sutton GL, Rootman DS. Applications of the femtosecond laser in corneal refractive surgery. Current Opinion in Ophthalmology 2011, 22:238-244.
<sup>8</sup> Duffey RJ, Leaming D. US Trends in Refractive Surgery: The 2009 ISRS Survey.
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## TECHNOLOGICAL CHARACTERISTICS COMPARISON
The LenSx Laser System is essentially the same device as the predicate LenSx Laser System with modifications made to improve usability and manufacturability. These modifications include:
- . Software updates to allow for the additional corneal flap pattern
- . An increase in the laser repetition rate from 33 kHz to 150 kHz for the flap pattern with maximum possible average power of 1 Watt.
- An increase in the laser repetition rate from 33 kHz to 50 kHz for patterns used for the . previously cleared indications in cataract and keratoplasty surgery with maximum possible average power of 1 Watt.
- Extension of shelf-life to 24 months for the sterile disposable patient interface. .
- Updated user labeling that describes the above changes, as well as changes to the . graphical user interface to improve usability.
## BRIEF SUMMARY OF PERFORMANCE TEST RESULTS
The performance data supporting substantial equivalence of the LenSx Laser with the above modifications include:
- Evaluation of the accuracy and reproducibility of the depths and geometry of each of . the previously cleared treatment patterns, as well as energy stability using the modified LenSx Laser in comparison to acceptance criteria established for the predicate LenSx Laser
- Evaluation of the accuracy and reproducibility of the depths and geometry and surface . quality of lamellar resections using the same parameter acceptance criteria.
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#### DEPARTMENT OF HEALTH & HUMAN SERVICES
Image /page/3/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features a stylized eagle with three tail feathers. The words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" are arranged in a circular pattern around the eagle.
Food and Drug Administration 10903 New Hampshire Avenue Document Control Room -WO66-G609 Silver Spring, MD 20993-0002
> SEP 6 2012
Alcon LenSx, Incorporated % Ms. Judy Gordon, D.V.M. ClinReg Consulting Services, Inc. Regulatory Consultant to Alcon LenSx, Inc. 733 Bolsana Drive Laguna Beach, CA 92651
Re: K120732
Trade/Device Name: LenSx® Laser system Regulation Number: 21 CFR 886.4390 Regulation Name: Ophthalmic laser Regulatory Class: Class II Product Code: OOE, HQC, HNO Dated: August 8, 2012 Received: February 23, 2012
#### Dear Ms. Gordon:
We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.
If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.
{4}------------------------------------------------
Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.
If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please go to http://www.fda.gov/AboutFDA/CentersOffices/CDRH/CDRHOffices/ucm115809.htm for the Center for Devices and Radiological Health's (CDRH's) Office of Compliance. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to
http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.
You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address
http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm.
Sincerely vours.
Kesia Alexander
Malvina B. Eydelman, M.D. Director Division of Ophthalmic, Neurological, and Ear, Nose and Throat Devices Office of Device Evaluation Center for Devices and Radiological Health
Enclosure
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510(k) Number (if known): K/20732
LenSx Laser System Device Name(s):
Indications for Use:
The LenSx Laser System is indicated for use:
- · In the creation of corneal cuts/incisions, anterior capsulotomy and laser
- phacofragmentation during cataract surgery. Each of these procedures may be performed either individually or consecutively during the same surgery.
- · In the creation of a lamellar cut/resection for lamellar keratoplasty, and in the creation of a penetrating cut/incision for penetrating keratoplasty.
- · In the creation of a corneal flap in patients undergoing LASIK surgery or other treatment requiring initial lamellar resection of the cornea.
MZ Burke Nicholas
(Division Sign-Off) Division of Ophthalmic, Neurological and Ear, Nose and Throat Devices
510(k) Number K120732
Prescription Use X (Part 21 CFR 801 Subpart D) AND/OR
Over-The-Counter Use (21 CFR 807 Subpart C)
(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)
Concurrence of CDRH, Office of Device Evaluation (ODE)
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1. Search: exact and fuzzy
Type a phrase like "coronary artery calcification" into the search box. You get two kinds of results. Exact results match the literal phrase — prefix searches work ("coronary artery calcificati") but suffix searches do not. Fuzzy results match on the meaning and intent of your phrase rather than the exact words, and are sorted by relevance score. Hover over the Exact or Fuzzy badge on any row to see exactly why it matched.
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Output name, acceptance criteria, observed values, development dataset description, and test dataset description. It's the same format we use for regulatory strategy output and Fast 510(k) input, and the fastest high-level fingerprint of an AI device. AI-generated but reliable in practice.
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Select multiple rows in the results table (aim for under ~10), then open the PDF Viewer tab. Ask one question — it goes to all selected devices in parallel, each with citations. This is the fastest way to compare and contrast devices: training data, PCCP scope, how they handled adding new scanners, and so on.
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Open the Predicates tab for a family-tree view of predicate relationships. Click a node to trace its parents and children; selections from search carry over pre-selected. Commonly predicated devices are worth reading — a lot of people predicated them for a reason. The visual lineage is also handy on client calls, e.g. to show how a predicate family evolved and justify why your predicate still holds.
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A lot of people predicated them for a reason. Clicking a node traces parents and children, and selections from search carry over pre-selected.
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The Embeddings tab plots every matching document in a 2-D "galaxy map" where semantically similar devices cluster together. Hover or click clusters to explore, and let AI label the clusters for you. Embeddings beat product codes for grouping: two devices can carry different product codes (LLZ vs. QIH) yet do the same thing — the embedding captures the meaning of the intended use and device story. This is also exactly how retrieval-augmented generation (RAG) works under the hood, and it makes a great visual on client calls.
Try it yourself
Head to the search page and work through a few of these AI/ML fuzzy searches to build intuition: perivascular fat on CT · aortic valve calcification opportunistic screening on noncontrast CT · breast cancer prediction on digital pathology slides · autism detection · gestational age prediction · a hearing aid that can also detect a pulse · foundation model based analysis of ECG · large language models · penetration test. Watch how the relevance scores, intended use, and AI Performance tables tell you when results stop being meaningful.