Femtosecond laser-assisted cataract surgery versus standard phacoemulsification cataract surgery: outcomes and safety in more than 4000 cases at a single center

Robin G Abell; Erica Darian-Smith; Jeffrey B Kan; Penelope L Allen; Shaun Y P Ewe; Brendan J Vote

doi:10.1016/j.jcrs.2014.06.025

Femtosecond laser-assisted cataract surgery versus standard phacoemulsification cataract surgery: outcomes and safety in more than 4000 cases at a single center

J Cataract Refract Surg. 2015 Jan;41(1):47-52. doi: 10.1016/j.jcrs.2014.06.025. Epub 2014 Nov 11.

Authors

Robin G Abell¹, Erica Darian-Smith¹, Jeffrey B Kan¹, Penelope L Allen¹, Shaun Y P Ewe¹, Brendan J Vote²

Affiliations

¹ From the Tasmanian Eye Institute (Abell, Darian-Smith, Kan, Allen, Ewe, Vote) and the Launceston Eye Institute (Vote), Tasmania, Australia.
² From the Tasmanian Eye Institute (Abell, Darian-Smith, Kan, Allen, Ewe, Vote) and the Launceston Eye Institute (Vote), Tasmania, Australia. Electronic address: eye.vote@bigpond.net.au.

PMID: 25466483
DOI: 10.1016/j.jcrs.2014.06.025

Abstract

Purpose: To compare the intraoperative complications and safety of femtosecond laser-assisted cataract surgery and conventional phacoemulsification cataract surgery.

Setting: Single center.

Design: Prospective consecutive comparative cohort case series.

Methods: Eyes had femtosecond laser-assisted cataract surgery (study group) or phacoemulsification (control group) by 1 of 5 surgeons. The technique comprised manual corneal incisions and capsulorhexis or laser-assisted anterior capsulotomy, lens fragmentation, corneal incisions, phacoemulsification, and intraocular lens implantation.

Results: The study group comprised 1852 eyes and the control group, 2228 eyes. Patient demographics were similar between groups. There was a significant improvement in vacuum/docking attempts, surface recognition adjustments, treatment, and vacuum time during the laser procedure in the study group. Anterior capsule tears occurred in 1.84% of eyes in the study group and 0.22% of eyes in the control group (P < .0001). There was no difference in the incidence of anterior capsule tears between the first half and second half of laser-assisted cases. Anterior capsulotomy tags occurred in 1.62% study group eyes. There was no significant difference in posterior capsule tears between the 2 groups (0.43% versus 0.18%). The incidence of significant intraoperative corneal haze and miosis was higher and the effective phacoemulsification time significantly lower in the study group (P < .001).

Conclusions: Significant intraoperative complications likely to affect refractive outcomes and patient satisfaction were low overall. The 2 cataract surgery techniques appear to be equally safe. Although anterior capsule tears remain a concern, the safety of femtosecond-assisted cataract surgery in terms of posterior capsule complications was equal to that of phacoemulsification.

Financial disclosure: No author has a financial or proprietary interest in any material or method mentioned.

Publication types

Comparative Study

MeSH terms

Aged
Cataract Extraction*
Corneal Pachymetry
Corneal Topography
Female
Humans
Intraoperative Complications
Laser Therapy*
Lens Implantation, Intraocular*
Male
Phacoemulsification / methods*
Prospective Studies
Pseudophakia / physiopathology
Tomography, Optical Coherence
Treatment Outcome
Visual Acuity / physiology