• Cataract Surgery: Comparing Outcomes of MCS and FLACS

    Written By: Lynda Seminara
    Selected By: Stephen D. McLeod, MD

    Journal Highlights

    Ophthalmology, August 2018

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    Berk et al. compared visual and refractive outcomes of femtosecond laser-assisted cataract surgery (FLACS) and manual cataract surgery (MCS) and found no significant differences between the 2 approaches.

    For this single-center, comparative, retrospective analysis, the authors looked at outcomes for eyes that received FLACS or MCS during a 37-month pe­riod. All told, 883 eyes underwent MCS and 955 received FLACS. Collected data included demographics, ocular history, preoperative measurements/biometry, and postoperative results. A generalized linear mixed model was used to analyze data, and adjustments were made for differences in baseline characteristics and for within-patient correlations. Two-tailed p values of <.05 were deemed significant.

    The main outcome measure was the percentage of eyes for which the abso­lute error (AE) was ≤0.5 D. Secondary outcomes were the percentages of eyes with AE ≤0.25 D and AE ≤1.0 D, and the proportions of distance-targeted eyes for which uncorrected distance visual acuity (UDVA) was 20/20 or bet­ter, 20/25 or better, and 20/30 or better.

    Three weeks after surgery, approxi­mately 83% of FLACS eyes and 79% of MCS eyes had AE ≤0.5 D, representing an adjusted odds ratio (OR) of 1.28 for FLACS relative to MCS (within this target range). Approximately 97% of eyes in both groups had AE ≤1.0 D at this time point (OR, 0.96); 49% of FLACS eyes and 46% of MCS eyes had AE ≤0.25 D (OR, 1.13).

    Factors that predicted favorable refractive outcomes were axial length of 22 to 24.8 mm, use of a toric intra­ocular lens, lower cylinder preopera­tively, and higher average keratometry preoperatively. There were no signifi­cant differences in the percentages of distance-targeted eyes with postopera­tive UDVA of 20/20 or better, 20/25 or better, or 20/30 or better.

    The original article can be found here.