FLACS vs. Standard Phacoemulsification Cataract Surgery
Journal of Cataract and Refractive Surgery
In a multicenter case-control study, Manning et al. compared the visual, refractive, and adverse outcomes of femtosecond laser–assisted cataract surgery (FLACS) and conventional phacoemulsification cataract surgery. They found that FLACS did not yield better visual or refractive outcomes than conventional phaco.
The researchers matched 2,814 FLACS cases performed by experienced surgeons in Europe and Australia to 4,987 conventional phaco cases drawn from the European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO). Matching criteria included baseline corrected distance visual acuity (CDVA), age, number of ocular comorbidities, and surgical risk factors. Intraoperative and postoperative complications and refractive outcomes were compared. Patient follow-up was 7 to 60 days.
Results obtained with FLACS and conventional phaco, respectively, were as follows: posterior capsule complications, 0.7% versus 0.4%; postoperative logMAR CDVA, 0.05 versus 0.03; postoperative CDVA worse at follow-up by 5 letters or more, 1.0% versus 0.4%; CDVA of 0.3 or better, 96.3% versus 97.1%; absolute biometry prediction error, 0.43 D versus 0.40 D; within ±0.5 D of target, 72% versus 74.3%; and postoperative complications, 3.4% versus 2.3%.
The researchers concluded that both FLACS and conventional phacoemulsification cataract surgery provided excellent visual outcomes, with few complications. However, they found no evidence to support claims that FLACS is superior to conventional phaco; in fact, postoperative complications were lower with the conventional surgery.
The original article can be found here.