Preliminary clinical investigation of cataract surgery with a noncontact femtosecond laser system

Abstract

Background and ObjectiveFemtosecond laser‐assisted cataract surgery (FLACS) is rapidly gaining popularity due to the improved consistency and predictability for capsulorhexis. This study aimed to investigate the preliminary clinical outcomes of FLACS with a noncontact femtosecond laser system.Patients and MethodsThis prospective study enrolled 25 eyes in the trial group underwent FLACS (LLS‐fs 3D, LENSAR, USA), and 29 eyes in the control group underwent conventional cataract surgery (Stellaris, Bausch & Lomb, USA). The phacoemulsification time, energy, and complications during operation were recorded. Postoperative refraction at 1 day, 1 week, 1 and 3 months, the capsulorhexis size and corneal endothelial density at 1 and 3 months were also measured.ResultsCompared to the control group, reduction in phacoemulsification time was 51.5% (P = 0.02), and in overall energy, 65.1% (P = 0.02) in the trial group. In the trial group and the control group, total time of cataract procedure was 10.04 ± 1.37 minutes, 10.52 ± 1.92 minutes, respectively (P = 0.31); the absolute difference between attempted and achieved capsulorhexis diameter at 1 month was 192.9 ± 212.0 µm, 626.9 ± 656.6 µm, respectively (P = 0.04), and at 3 months, 256.6 ± 181.9 µm, 572.1 ± 337.0 µm, respectively (P= 0.03); the absolute difference between attempted and achieved spherical equivalent at 3 months was 0.16 ± 0.16 D, 0.74 ± 0.65 D, respectively (P < 0.01); mean corneal endothelial cell loss at 1 month was 15.6% and 14.2%, respectively (P = 0.77), and at 3 months, 2.9%, 4.2%, respectively (P = 0.50).ConclusionsWith the noncontact femtosecond laser system, FLACS can significantly improve the accuracy and repeatability of capsulorhexis, reduce the phacoemulsification time and overall energy, and enhance the predictability and stability of postoperative refraction. Lasers Surg. Med. 47:698–703, 2015. © 2015 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.

A Meta-Analysis Comparing Postoperative Complications and Outcomes of Femtosecond Laser-Assisted Cataract Surgery versus Conventional Phacoemulsification for Cataract

“…The heterogeneity might be attributed to various regional background, follow-up period, and surgical expertise. For instance, heterogeneity in refractive outcomes was significantly reduced (0%) after we removed the Chinese patients in Yu et al [16]. Further, we performed sensitivity analysis, and the nonreversed results confirmed that the conclusion of our meta-analysis was reliable.…”

Safety of femtosecond laser‐assisted cataract surgery: assessment of aqueous humour and lens capsule

“…; Yu et al. ). Ultrasound energy may damage surrounding structures and may be implicated in the pathogenesis of endothelial cell loss (Dick et al.…”

“…; Yu et al. ). The improvement in capsulotomy diameter and regularity has been linked with significantly better IOL centration (Nagy et al.…”

“…; Yu et al. ). What's more, FLACS can be tried in complex cases such as Marfan's syndrome and paediatric cataract (Abouzeid & Ferrini ; Crema et al.…”

“…; Yu et al. ). Femtosecond laser‐assisted cataract surgery (FLACS) produces enormous energy on a very narrow space and dissects tissue by photodisruption (Hansen et al.…”