Plea for femtosecond laser pre-treatment and cataract surgery in the same room

Dick, H. Burkhard; Gerste, Ronald D.

doi:10.1016/j.jcrs.2014.01.005

Cited by 28 publications

(9 citation statements)

References 7 publications

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“…There was no significant difference in surgically induced astigmatism (SIA) and astigmatism axis or CCT between the pre- and postoperative values for both groups, as has been found previously. 29–31 Moreover, our findings regarding ECC demonstrate the endothelial sparring effect of the femtosecond laser, likely due to the reduction in overall phaco energy which has been shown to harm the endothelium. The positive impact of FLACS on the endothelium has been widely reported in the literature and appears to be consistently present regardless of what device is used.…”

Section: Discussionmentioning

confidence: 65%

“…The positive impact of FLACS on the endothelium has been widely reported in the literature and appears to be consistently present regardless of what device is used. 30,31 Endothelial cell loss is a critical clinical concern in patients whose endothelium is already compromised due to corneal diseases or trauma. In these patients, FLACS may provide a clinical benefit.…”

Section: Discussionmentioning

confidence: 99%

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Bimanual femtosecond laser-assisted cataract surgery compared to standard bimanual phacoemulsification: A case–control study

Cavallini

Fornasari

Maria

et al. 2018

European Journal of Ophthalmology

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Purpose: To evaluate the efficacy and safety of bimanual, low-energy femtosecond laser-assisted cataract surgery with 1.4-mm microincisions compared to standard bimanual phacoemulsification (bimanual microincision cataract surgery). Design: Prospective, non-randomized comparative case series. Methods: Bimanual femtosecond laser-assisted cataract surgery with microincisions was performed on 80 eyes (Group A) with the low-energy Ziemer LDV Z8; a matched case–control series of 80 eyes performed with standard bimanual microincision cataract surgery technique was selected for comparison (Group B). All interventions were performed by the same experienced surgeon. Intraoperative parameters were recorded as well as intra- and postoperative complications. Best corrected visual acuity, surgically induced astigmatism, central corneal thickness and endothelial cell count were evaluated before surgery and at 1 and 3 months post intervention. Results: The mean effective phaco times were 3.79 ± 2.19 s (Group A) and 4.49 ± 1.84 s (Group B) (p = 0.041). No major intra- or postoperative complications occurred. An overall significant mean best corrected visual acuity improvement was noted at 3 months, but was not statistically different between the groups. No significant changes were observed for surgically induced astigmatism or corneal pachymetry. A significant loss of endothelial cell count in both groups was detected at 3 months, with Group A reporting a significantly lower endothelial cell count loss compared to Group B (p = 0.009). Conclusion: Bimanual, low-energy femtosecond laser-assisted cataract surgery with 1.4-mm microincisions by an expert surgeon was proven to be safe and effective in this study. This technique has advantages compared with standard bimanual microincision cataract surgery in terms of endothelial preservation.

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Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Bimanual femtosecond laser-assisted cataract surgery compared to standard bimanual phacoemulsification: A case–control study

Cavallini

Fornasari

Maria

et al. 2018

European Journal of Ophthalmology

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“…If the patient is swiveled around on his treatment bed from under the laser platform to the adjoining position under the operating microscope immediately, the prostaglandins released by capsulotomy hardly have the time to exert their effect on the muscularis sphincter pupillae. This is one argument—besides, for instance, hygienic considerations—in favor of performing laser treatment and the following steps such as lens removal and IOL in the same operating room instead of doing the former in a separate “laser suite” [35]. …”

Section: Safetymentioning

confidence: 99%

A Review of Laser-Assisted Versus Traditional Phacoemulsification Cataract Surgery

Dick

Schultz

2017

Ophthalmol Ther

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The use of femtosecond laser surgery improves the precision and reproducibility of corneal incisions and the capsular opening; it also reduces the amount of ultrasound energy required for lens nucleus work-up. The rate of complications reported so far appears to be low. There are a number of contraindications such as a history of cornea and/or glaucoma surgery and certain anatomical features like deep-set eyes, kyphosis, tremor, and obesity. Visual recovery and refractive results of both techniques are excellent. Comparing laser cataract surgery (LCS) with manual cataract surgery (conventional phacoemulsification) based on meta-analysis currently reveals slight differences in refractive and visual outcome. Both methods are extremely successful and safe. LCS is a technique still on the rise, with its full potential not yet tapped.

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“…For instance, due to the substantial clinical footprint of a femtosecond laser, almost all available platforms require their own dedicated room which is expensive, particularly in city hospitals where space comes at a premium. Additionally, unlike other theatre equipment, most FLACS lasers are completely immobile which means patients must be shuttled between rooms to complete surgery which not only adds time and increases risk of infection but also creates an additional liability burden for a hospital in the event that a patient sustains an injury during the transfer [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Femtosecond laser-assisted cataract surgery in a public teaching hospital setting

2018

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BackgroundTo evaluate the efficiency and practicality of femtosecond laser assisted cataract surgery (FLACS) in a public teaching hospital setting using a mobile FLACS system compared to conventional phacoemulsification cataract surgery (CPCS).MethodsNinety eyes from 90 patients underwent either FLACS or CPCS (45 in each group). Cataracts were graded using the Lens Opacities Classification System III system. Outcome measures included total surgery duration, femtosecond laser treatment time, vacuum time (VT), total phacoemulsification time (TPT) and total phacoemulsification power (TPP).ResultsNo differences were observed in the preoperative mean cataract grades and co-morbidities. FLACS took longer than CPCS with a mean difference of 5.2 ± 4.5 min (range: 0–18.8 min). The average femtosecond laser treatment time was 4.3 ± 3.4 min (range: 1–15.5 min). The VT was 2.51 ± 0.45 min (range: 1.59–4.10 min). Although not significant, TPT in FLACS showed a trend towards improvement (mean 1.0 ± 0.6 s; range: 0.1–2.4 s) compared to CPCS (mean 1.2 ± 0.6 min; range: 0.5–2.5 min). Whereas, TPP was significantly less in FLACS (mean 17.9 ± 5.0%; range: 5–27%) compared to CPCS (mean 20.3 ± 4.1%; range: 12.0–28.7%)(p = 0.031).ConclusionsThe mobile FLACS system housed in the same operating room increased the surgical duration by 5.2 min. The average VT was 2.51 min, which was lower in comparison to published experience using non-mobile FLACS systems.

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Plea for femtosecond laser pre-treatment and cataract surgery in the same room

Cited by 28 publications

References 7 publications

Bimanual femtosecond laser-assisted cataract surgery compared to standard bimanual phacoemulsification: A case–control study

Bimanual femtosecond laser-assisted cataract surgery compared to standard bimanual phacoemulsification: A case–control study

A Review of Laser-Assisted Versus Traditional Phacoemulsification Cataract Surgery

Femtosecond laser-assisted cataract surgery in a public teaching hospital setting

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