Learning curve of femtosecond laser-assisted cataract surgery: Experience of surgeons new to femtosecond laser platform

Abstract

Purpose:The purpose of this study is to assess the learning curve in the initial 100 cases of cataract surgery performed using femtosecond laser-assisted cataract surgery (FLACS) by experienced cataract surgeons without prior experience in femtosecond laser platform.Methods:This study was conducted at tertiary care eye hospital, South India. This was a prospective interventional study. The first 100 consecutive eyes undergoing FLACS were studied to understand docking time, number of docking attempts, problems encountered during docking, and complications attributable to docking. Phacoemulsification performed after femtosecond laser was also studied for complications, need for additional instrumentation, and total time required for surgery. Comparison was also made between two operating surgeons.Results:Successful docking was recorded in 70% eyes at the first attempt. Mean time taken for successful docking was 9.3 ± 6.4 min (median = 6 min, interquartile range (IQR) = 5–10 min, range = 4–35 min). When surgeries were divided into quartiles, docking time reduced significantly from 16.2 ± 7.9 min in the first quartile to 6.2 ± 2.7 min in the fourth quartile (P < 0.001). Phacoemulsification postdocking required 12.9 ± 6.2 min (median = 10 min, IQR = 9–17.5 min). Six eyes showed anterior capsular tags, one had radial extension of capsulorhexis, and two eyes showed pupillary miosis after femtosecond laser application. At 6 weeks, 79% eyes attained uncorrected vision of 20/20, and all eyes had best-corrected vision of 20/20.Conclusion:Approximately 25–30 cases were required before obtaining reproducible results with FLACS, irrespective of cataract surgical experience, suggesting that training programs must offer a minimum 25 surgeries. Very few complications occurred during the learning curve, making it patient friendly.

Femtosecond laser-assisted cataract surgery in Alport's syndrome - A case report

“…[3] FLACS also has a higher learning curve, especially for non-LASIK (laser-assisted in situ keratomileusis) surgeons not used to the femtoplatform. [56] However, in tough situations such as lenticonus, it definitely improves surgical safety with more predictable outcomes as seen with our case. Previously, FLACS in anterior lenticonus has been reported only twice.…”

Intraoperative OCT vs Scheimpflug and swept-source OCT measurements for anterior eye parameters

“…5,9 In addition, the surgeons' skills are critical to achieve satisfying postoperative results. 10,11 Currently, special focus is given on the use of minimal invasive surgery techniques. On the basis of this, femtosecond laser-assisted cataract surgery (FLACS) gets common to prevent postoperative complications.…”

Outcomes of Femtosecond Laser Assisted Cataract Surgery Performed by Resident and Attending Surgeons

“…New surgical technology is often accompanied with a learning curve and the potential for an increased number of operative complications, and FLACS is no exception. Bali et al and Christy et al 20 both describe a learning curve with attending surgeons first using femtosecond laser in their cataract practice. Our study likewise supports this finding; the resident FLACS group had the greatest complication rate at 20%, which was three times greater than the attending FLACS group; however, the difference was not statistically significant ( p = 0.30).…”