Laser-assisted cataract surgery versus standard ultrasound phacoemulsification cataract surgery

Day, Alexander C; Gore, Daniel M.; Bunce, Catey; Evans, Jennifer R

doi:10.1002/14651858.cd010735.pub2

Cited by 118 publications

(125 citation statements)

References 48 publications

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“…In our patients we found similar surgical outcomes to those published with traditional manual cataract surgery regarding IOP, VA, and VF, with the added advantage of femtosecond laser precision. 13 Suction was well tolerated in glaucomatous eyes during surgery, showing no signi cant mean IOP raise immediately after suction docking or up to our 90-day nal follow-up. This contrasts with previous studies of FLACS performed in glaucomatous eyes.…”

Section: Discussionmentioning

confidence: 70%

“…11,12 The superiority of FLACS compared to manual phacoemulsi cation cannot be determined with the evidence available today. 13 Considering the characteristics of glaucoma patients, and the added risk of IOP rising during the docking procedure in eyes with an additional vulnerability to IOP changes, we nd it is important to assess the outcomes of FLACS in this population.…”

Section: Introductionmentioning

confidence: 99%

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Femtosecond Laser-Assisted Cataract Surgery in Glaucoma Patients, Case Series.

Alvarez-Ascencio

Prado-Larrea

Jiménez-Román

et al. 2020

Preprint

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BackgroundWe aim to describe the short-term effect of femtosecond laser-assisted cataract surgery (FLACS) in intraocular pressure (IOP), visual acuity (VA), number of hypotensive medications, and visual fields (VF) in glaucomatous eyes.MethodsSingle-center consecutive case series study included patients with a previous glaucoma diagnosis that needed cataract surgery alone or combined with incisional glaucoma procedure. IOP was measured during surgery immediately before and after pretreatment docking with an indentation tonometer. Changes in visual acuity (VA), IOP, number of medications, and VF were evaluated with a 90 day follow up.ResultsTwenty-seven eyes of 27 patients were included. Mean patient age was 70 years, 70% (n = 19) were female. Glaucoma diagnoses were: twelve patients with primary open-angle glaucoma, 13 with angle-closure glaucoma, and 2 with pseudoexfoliation glaucoma. Twenty-one patients underwent cataract surgery alone and 6 combined with an incisional glaucoma procedure (trabeculectomy or glaucoma drainage device implantation). We found no significant differences between pre-docking IOP (17.59 mmHg ± 6.25 SD) and post-docking IOP (17.23 mmHg ± 7.74 SD) p = 0.7. No surgical complications were recorded. The 90-day postoperative follow up revealed no changes from baseline regarding VF mean deviation, mean IOP, and the number of glaucoma medications decreased in both groups.ConclusionFLACS appears to perform well in the short-term in eyes with glaucoma undergoing cataract surgery alone or with an incisional glaucoma procedure. Comparable outcomes to manual phacoemulsification were obtained regarding IOP, VA, and postoperative period evolution.Clinical SignificanceSafety and efficacy of FLACS have not been properly studied in the glaucoma population, we present a case series with different glaucoma diagnoses who underwent FLACS alone or with an incisional glaucoma procedure.

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Section: Discussionmentioning

confidence: 70%

Section: Introductionmentioning

confidence: 99%

Femtosecond Laser-Assisted Cataract Surgery in Glaucoma Patients, Case Series.

Alvarez-Ascencio

Prado-Larrea

Jiménez-Román

et al. 2020

Preprint

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“…The cataract surgery pharmacological support in glaucoma patients (including 0.5 % levofloxacin, 0.09 % bromfenac and preservative free polyvinylpyrrolidone and polyvinyl alcohol fixed combination instillations) showed: high efficiency (in prevention of infectious and inflammatory complications); safety by influence on the ocular surface; comfort of use. Keywords: cataract surgery, glaucoma, pharmacological support, ocular surface, 0.09 % bromfenac For citation: Катарактальная хирургия, включая ультразвуковую факоэмульсификацию (ФЭК) и фемтолазер-ассистированную ФЭК, является высокоэффективным и безопасным вмешательством [1,2]. Вместе с тем в послеоперационном периоде у части пациентов возможно появление или отягощение клинических проявлений синдрома «сухого глаза» (ССГ), снижающих удовлетворенность результатами лечебного воздействия [3][4][5][6][7].…”

Section: Discussionunclassified

“…Effectiveness and Safety of Cataract Surgery Pharmacological Support in Glaucoma Patients S.V. Yanchenko 1,2 , A.V. Malyshev 1,2 , S.N.…”

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confidence: 99%

Effectiveness and Safety of Cataract Surgery Pharmacological Support in Glaucoma Patients

et al. 2018

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Purpose:To evaluate effectiveness and safety of cataract surgery pharmacological support (which include 0.5 % levofloxacin, 0.09 % bromfenac and preservative free polyvinylpyrrolidone and polyvinyl alcohol fixed combination instillations) in glaucoma patients.Patients and Methods:Standard ophthalmological examination, subjective discomfort level evaluation, tear film break up time, tear meniscus height measurement, index of xerosis, evaluation and ocular surface condition photoregistration were performed in 40 II «A» primary open-angle glaucoma patients, receiving hypotensive therapy, before and after phacoemulsification (Ph). All patients in the postoperative period received instillations: 0.5 % levofloxacin (4 times a day, 7 days), 0.1 % dexamethasone (3 times a day, 7 days), 0.09 % bromfenac (once a day, 30 days) and preservative free polyvinylpyrrolidone and polyvinyl alcohol fixed combination (3 times a day, 30 days). Control points were: examination before Ph, on 1, 7 and 30 days after Ph. Results: None cases of infectious or inflammatory surgery complications were recorded. The SD level was significantly increased on the 1 and 7 days after Ph, by the 30 day the SD level was significantly decreased, compared with a state on the 1 and 7 days. On the 1, 7, 30 days after Ph TFBUT significantly decreased. By the 30 day after Ph the TFBUT was significantly increased in compare with 1 and 7 days after operation. TMH changes after Ph had multidirectional character and in general were not significant throughout the observation, with a tendency to increase on the 1 and 30 days after surgery and to decrease on the 7th day. IX dynamics in compare with a state before Ph was not significant in all control points with a tendency to its increase on the 1 and 7 days after operation and to decrease on the 30th day. In general, pharmacological support of Ph was assessed by all patients as comfortable, there was no intolerance.Conclusion:The cataract surgery pharmacological support in glaucoma patients (including 0.5 % levofloxacin, 0.09 % bromfenac and preservative free polyvinylpyrrolidone and polyvinyl alcohol fixed combination instillations) showed: high efficiency (in prevention of infectious and inflammatory complications); safety by influence on the ocular surface; comfort of use.

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“…A meta-analysis study concluded that FLACS was not superior to conventional phacoemulsification surgery in terms of intraoperative and postoperative complications [102]. A Cochrane systematic review including 16 randomized clinical trials that compared FLACS with conventional phacoemulsification surgery also failed to determine the superiority of FLACS [103]. erefore, further development of FLACS would be needed to provide significant improvement in safety and efficacy and to reduce costs to keep health systems sustainable.…”

Section: Limitations and Complicationsmentioning

confidence: 99%

Application of Femtosecond Laser in Anterior Segment Surgery

Han

Liu

Mohamed-Noriega

2020

Journal of Ophthalmology

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Femtosecond laser (FSL) is a near-infrared laser that can create reliable and reproducible tissue cutting with minimal damage to adjacent tissue. As the laser can also create incisions with various orientations, depths, and shapes, it is expected to be a useful tool for anterior segment surgery, such as cornea, refractive, and cataract surgery. In this review, the authors will introduce the application of FSL in various anterior segment surgeries and discuss the results of studies regarding the efficacy and safety of FSL in cornea, refractive, and cataract surgery. Experimental studies regarding the potential use of FSL will also be introduced. The studies discussed in this review suggest that FSL may be a useful tool for improving the prognosis and safety of surgeries of the anterior segment.

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Laser-assisted cataract surgery versus standard ultrasound phacoemulsification cataract surgery

Abstract: Laser-assisted cataract surgery versus standard ultrasound phacoemulsification cataract surgery.

Cited by 118 publications

References 48 publications

Femtosecond Laser-Assisted Cataract Surgery in Glaucoma Patients, Case Series.

Femtosecond Laser-Assisted Cataract Surgery in Glaucoma Patients, Case Series.

Effectiveness and Safety of Cataract Surgery Pharmacological Support in Glaucoma Patients

Application of Femtosecond Laser in Anterior Segment Surgery

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