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

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.

• Authors: Robin G Abell, Erica Darian-Smith, Jeffrey B Kan, Penelope L Allen, Shaun Y P Ewe, Brendan J Vote
• Journal: Journal of cataract and refractive surgery (J Cataract Refract Surg) Vol. 41 Issue 1 Pg. 47-52 (Jan 2015) ISSN: 1873-4502 [Electronic] United States
• PMID: 25466483 (Publication Type: Comparative Study, Journal Article)
• Copyright: Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Topics

• 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)