Surgical outcomes and safety of femtosecond laser cataract surgery: a prospective study of 1500 consecutive cases

Ophthalmology. 2013 Feb;120(2):227-33. doi: 10.1016/j.ophtha.2012.10.026. Epub 2012 Dec 6.


Objective: To report the surgical outcomes and safety of femtosecond (FS) laser cataract surgery (LCS) with greater surgeon experience, modified techniques, and improved technology.

Design: Prospective, interventional case series.

Participants: Fifteen hundred consecutive eyes undergoing FS laser cataract and refractive lens exchange surgery in a single group private practice.

Intervention: Femtosecond LCS.

Methods: All eyes undergoing LCS between April 2011 and March 2012 were included in the study. Cases underwent anterior capsulotomy, lens fragmentation, and corneal incisions with the Alcon/LenSx FS laser (Alcon/LenSx, Aliso Viejo, CA). The procedure was completed by phacoemulsification and insertion of an intraocular lens. The cases were divided into 2 groups: Group 1, initial experience consisting of the first 200 cases; and group 2, the subsequent 1300 cases performed by the same surgeons.

Main outcome measures: Intraoperative complication rates and comparison between groups.

Results: Both groups were comparable for baseline demographic parameters. Anterior capsule tears occurred in 4% and 0.31% of eyes, posterior capsule tears in 3.5% and 0.31% of eyes, and posterior lens dislocation in 2% and 0% of eyes in groups 1 group 2, respectively (P<0.001 for all comparisons). Number of docking attempts per case (1.5 vs 1.05), incidence of post-laser pupillary constriction (9.5% vs 1.23%), and anterior capsular tags (10.5% vs 1.61%) were significantly lower in group 2 (P<0.001 for all comparisons).

Conclusions: In the authors' experience, the surgical outcomes and safety of LCS improved significantly with greater surgeon experience, development of modified techniques, and improved technology.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cataract Extraction / methods*
  • Cornea / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Intraoperative Complications
  • Laser Therapy*
  • Lens Capsule, Crystalline / surgery
  • Lens Implantation, Intraocular*
  • Male
  • Middle Aged
  • Prospective Studies
  • Pseudophakia / physiopathology
  • Refraction, Ocular / physiology
  • Treatment Outcome
  • Visual Acuity / physiology