Meta-analysis finds better profile for femtosecond cataract surgery compared with conventional cataract surgery
MAASTRICHT, Netherlands — A systematic review and meta-analysis of studies comparing conventional and femtosecond laser-assisted cataract surgery showed similarly good results but an overall superior profile for the femtosecond procedure.
“We systematically searched the peer-reviewed literature, the Medicine Cochrane Library and Embase according to PRISMA guidelines. We included only prospective and retrospective trials where both FLACS and conventional cataract surgery were performed and compared. Overall, we found 42 studies, for a total of 9,400 eyes receiving FLACS compared to 8,779 eyes receiving conventional surgery,” Thomas Kohnen, MD, PhD, said at the European Society of Cataract and Refractive Surgeons winter meeting.
Better results with FLACS were reported for uncorrected distance visual acuity and circularity of the capsulotomy. Central corneal thickness measured at 1 day and 1 month also showed an advantage for FLACS. Effective phaco time was slightly less with femto and comparable with the different lasers, namely Catalys (Abbott Medical Optics), LenSx (Alcon) and Victus (Bausch + Lomb). In terms of corrected distance vision, there was a tendency toward better results but no significant difference, and no difference was found for macular edema and IOP within 24 hours.
“Anterior capsule rupture was the only disadvantage of FLACS, mainly due to one of the studies included in our analysis. The rate will further decrease over time with the advances of laser energy. No difference was found in the rate of posterior capsule rupture,” Kohnen said.
He expressed disagreement and wrote a letter to the editor in relation to a new paper soon to be published in Ophthalmology by Popovic and colleagues that reported significantly more posterior capsule tears with FLACS. The conclusions of this study were based on inaccurate and inconsistent datasets, he said. – by Michela Cimberle
Kohnen T, et al. Update on the comparison of femtosecond laser-assisted lens surgery to conventional cataract surgery: a systematic review and meta-analysis. European Society of Cataract and Refractive Surgeons winter meeting; Feb. 10-12, 2017; Maastricht, Netherlands.
Disclosure: Kohnen reports no relevant financial disclosures.