Femtosecond Laser-Assisted Cataract Surgery: A Report by the American Academy of Ophthalmology

Charles C Lin; Jennifer R Rose-Nussbaumer; Zaina N Al-Mohtaseb; Seth M Pantanelli; Walter Allan Steigleman 3rd; Kathryn M Hatch; Marcony R Santhiago; Stephen J Kim; Julie M Schallhorn

doi:10.1016/j.ophtha.2022.04.003

Femtosecond Laser-Assisted Cataract Surgery: A Report by the American Academy of Ophthalmology

Ophthalmology. 2022 Aug;129(8):946-954. doi: 10.1016/j.ophtha.2022.04.003. Epub 2022 May 13.

Authors

Charles C Lin¹, Jennifer R Rose-Nussbaumer², Zaina N Al-Mohtaseb³, Seth M Pantanelli⁴, Walter Allan Steigleman 3rd⁵, Kathryn M Hatch⁶, Marcony R Santhiago⁷, Stephen J Kim⁸, Julie M Schallhorn⁹

Affiliations

¹ Department of Ophthalmology, Byers Eye Institute, Stanford University, Stanford, California.
² Department of Ophthalmology, Byers Eye Institute, Stanford University, Stanford, California; Francis I. Proctor Foundation, University of California, San Francisco.
³ Department of Ophthalmology, Baylor College of Medicine, Houston, Texas.
⁴ Department of Ophthalmology, Penn State College of Medicine, Hershey, Pennsylvania.
⁵ Department of Ophthalmology, University of Florida College of Medicine, Gainesville, Florida.
⁶ Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts.
⁷ Department of Ophthalmology, University of Sao Paulo, Sao Paulo, Brazil.
⁸ Department of Ophthalmology, Vanderbilt University School of Medicine, Nashville, Tennessee.
⁹ Department of Ophthalmology, University of California, San Francisco, California.

Abstract

Purpose: To evaluate refractive outcomes, safety, and cost-effectiveness of femtosecond laser-assisted cataract surgery (FLACS) compared with phacoemulsification cataract surgery (PCS).

Methods: A PubMed search of FLACS was conducted in August 2020. A total of 727 abstracts were reviewed and 33 were selected for full-text review. Twelve articles met inclusion criteria and were included in this assessment. The panel methodologist assigned a level of evidence rating of I to all 12 studies.

Results: No significant differences were found in mean uncorrected distance visual acuity, best-corrected distance visual acuity, or the percentage of eyes within ± 0.5 and ± 1 diopter of intended refractive target between FLACS and PCS. Intraoperative and postoperative complication rates were similar between the 2 groups, and most studies showed no difference in endothelial cell loss between FLACS and PCS at various time points between 1 and 6 months. In large randomized controlled studies in the United Kingdom and France, FLACS was less cost-effective than PCS.

Conclusions: Both FLACS and PCS have similar excellent safety and refractive outcomes. At this time, one technique is not superior to the other, but economic analyses performed in some populations have shown that FLACS is less cost-effective.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Cataract Extraction* / methods
Cataract*
Humans
Laser Therapy* / methods
Lasers
Ophthalmology*
Phacoemulsification* / methods

Abstract

Publication types

MeSH terms

Grants and funding