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Quiñones A, Gleitsmann K, Freeman M, et al. Benefits and Harms of Femtosecond Laser Assisted Cataract Surgery: A Systematic Review [Internet]. Washington (DC): Department of Veterans Affairs (US); 2013 Dec.

Cover of Benefits and Harms of Femtosecond Laser Assisted Cataract Surgery: A Systematic Review

Benefits and Harms of Femtosecond Laser Assisted Cataract Surgery: A Systematic Review [Internet].

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CodeDefinitionExclusion criteria/notesKQ1 – BenefitsKQ2 –Adverse effectsKQ3 – Learning curve
Include; addresses KQ1, KQ2, or KQ3
SR = systematic review
KQ1: What are the benefits of FLACS compared with conventional cataract surgery?KQ2a: What are the unique risks associated with FLACS?
KQ2b: What are the risks of FLACS compared to conventional cataract surgery?
KQ3: What are the intra-operative and post-operative risks of FLACS with regard to the experience f the surgeon?
X1Non-English language
X2Does not pertain to femtosecond laser technology
X3Intervention not in scopeExclude studies of lasers used for procedures other than cataract surgeryIncluded interventions: femtosecond lasers used for cataract surgery applicationsSame interventions as KQ1Same interventions as KQ1
X4Study population not in scopeNote: FLACS is contraindicated in the following populations: advanced glaucoma; high anxiety; tremors; dementia; facial or ocular anatomy that precludes dockingIncluded population: adults undergoing cataract surgerySame population as KQ1.Same population as KQ1
X5No primary data or study design not in scope, according to each KQ.Exclude non-systematic or narrative reviews, editorials and opinions. Add code B (e.g. X5-B) to consider using the article in Discussion, or possibly describe the study data as a lower level of evidence.Include controlled study designs:
  • Randomized controlled trials (RCTs)
  • Non-randomized controlled clinical trials
  • Controlled before/after studies
Included study designs for harms:
  • Controlled studies
  • Quasi-experimental studies
  • Cohort studies
  • Case-control studies
Excluded study designs:
  • Case reports
  • Case series
  • Same study designs listed for KQ2
  • Cost-evaluation studies
X6Outcomes that are not in scopeShort-term patient outcomes:
  • Visual acuity: postoperative day 1
Long-term patient outcomes:
  • Visual acuity: after postoperative day 1 (typically recorded after 1 week, 1 month, or 90 days)
  • Quality of life (QOL) measures
Intra-operative complications:
  • Capsular blockage syndrome
  • Dislocated nucleus
  • Capsular tear
Post-operative complications:
  • Infection
  • Retinal swelling/cystoid edema (CME)
  • Intraocular (IOL) decentration
  • Corneal edema
Other reported harms
  • Cost
  • All other specified outcomes
X7Other reason: specifyAdd comments or keywords as needed.
X99Full text not accessible
BBackgroundAdd to any of the above X codes (e.g., X5-B) if the article contains information that may be useful for the introduction, discussion, limitations, future research, or other contextual purposes. Add comments or keywords as needed.


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